This is an open letter to all New Zealand District Health Board (DHB) members examining previous and currently appointed DHB board members’ involvement in New Zealand’s largest medical fraud malpractice – laparoscopic cholecystectomy surgery – for the treatment of gallstones and gallbladder problems. DHBs’ have continually been in breach of patients’ rights under the Health and Disability Commissioner Act 1994 and the Code of Ethics of the New Zealand Medical Association. Furthermore, DHBs’ have been in breach of International Human Rights law, which New Zealand is a party to under the Universal Declaration of Human Rights (UDHR). There has been a blatant disregard for breaches of patients’ rights by all DHBs.
In early 2016, we presented your predecessors with significant and credible evidence that was supported by medical studies and patient testimonies confirming medical malpractice. We exposed that patients have been defrauded of their right to receive informed consent. At the time simple requests were put to DHBs’ to ask patients in post-operation recovery whether they provided legal consent for laparoscopic cholecystectomy and were aware of the side effect risks and alternative treatment options available? The response received was not forthcoming, which in the eyes of many confirmed fraudulent behaviour from surgeons under the employment of DHBs.
As a direct result of DHBs’ non-action, past and present, board members have chosen to continue to ignore this abhorrent behaviour that has resulted in an unprecedented amount of harm, unnecessary injuries and deaths amongst patients receiving cholecystectomy surgery. As such, liability exists vicariously for DHBs.
Based on the lack of action and lack of accountability from DHBs up to this point in time we have taken significant steps to rectify the continuation of illegal medical malpractice. Our patient advocacy project has taken steps to help ensure patient safety.
This patient advocacy project is established by victims of medical fraud to promote the protection of the legal and ethical rights of health consumers, which include but are not limited to:
- The right to be protected from exploitation and medical malpractice, including fraudulent behaviour to obtain informed consent, inflict cruel, inhumane and degrading treatment on patients; and
- The legal right to give informed consent, also known as the patient right to autonomy,
- The right to have services provided in a legal and ethical manner, free from exploitation and coercion, to minimise the potential harm to patients and optimise their quality of life; and
- The right to post-treatment care support for when known health complications establish, or chronic illnesses arise that diminish patients’ quality of life.
In our role as a patient advocacy group, we have taken the following steps to stop the harm and obtain treatment support for cholecystectomy patients:
- We are contacting every cholecystectomy patient treated through your DHB using a variety of mediums, including print and media outlets, to expose treatment conducted illegally. Furthermore, we intend to expose the proliferation of misinformation and falsities about the risk of certain side effects, which may significantly impact patients’ quality of life. We vociferously believe that patients’ have been blocked from receiving post-care treatment support in order to cover-up culpability.
- Prove, with evidence, New Zealand surgeons are lying incessantly about the surgery and treatment options and brutally harming patients by blocking post-treatment support care:
- We have 1500+ patient testimonies, many of which describe crippling health complications and New Zealand surgeons’ strongly deny their existence. Instead they argue the side effects are not a result of their tenement so no post-care support should be provided, despite a mounting body of evidence to the contrary.
- We have published examples of false, misleading and fraudulent patient information documentation used by surgeons and signed off by your DHB, to illegally obtain consent through deception. There is a consistent misrepresentation of the facts that have been deliberate crafted to conceal all side effects risks and alternative non-surgical treatment options. Instead, there is a preference to utilise surgery as a treatment option purely for the financial gain of the surgeon.
- Prove there is existing fraud by false representation and a criminal offence occurring under the Crimes Act 1961, Section 240. (See www.hdcfraud.com/dhbfraud)
- Prove, with evidence, the HDC is providing protection to doctors and expose their possible conspiracy to obstruct justice and their failure to identify the patient’s Code of Rights breaches. As such, the HDC could even be held liable as an accessory to resulting patient deaths:
- We are posting a reward (increased to $100,000) asking for proof that evidence and information provided to obtain consent is not misleading, deceptive and fraudulent (and under the protection of the HDC). (See www.hdcfraud.com/100k-reward)
- We are publishing the HDC investigations of cholecystectomy patients, exposing fraud. (See www.hdcfraud.com/the-protection)
- Holding to account those directly responsible and those who are accessories to New Zealand’s largest medical fraud for breaching patients’ rights and causing harm, this letter is published for all to see.
Illegal conduct in more detail, as previously advised:
Gallbladder surgery (cholecystectomy) for treatment of gallstones is being carried out in a manner that is illegal and compromising the safety of patients, and also compromising their legally enforceable rights, under the HDC Code of Rights. A laparoscopic cholecystectomy surgery is promoted as the only option for patients and is presented as a mandatory option – or medical practitioners will simply do nothing to help patients. Effectively, this has been guaranteeing revenue for surgeons, at a future stage, when patients have no option but to take the surgical route as a course of action.
In order to obtain consent, New Zealand surgeons are openly lying to patients. Surgical treatment is currently presented as having no lasting side effects and patients are led to believe that they can live a normal life, return to a normal diet and not have the risk of digestive problems after gallbladder removal.
In order to maintain the fraud, once the well-documented side effects become established and detrimentally affect patient health, New Zealand surgeons’ have taken extraordinary steps to ensure that post-surgery complications are not diagnosed and treatment support is not provided to patients. Correct diagnosis and treatment of complications would contradict surgeons’ claims made to patients.
The response of DHB’s and the collective failure to act on patient safety complaints with easily verifiable evidence, presents the DHB’s as vicariously liable as employers. As such, DHB’s may be found criminally liable and culpable for their part in this malpractice:
Employers are vicariously liable under Section 72(2) of the Health and Disability Commissioner Act 1994 (the Act) for any breach of the Code by an employee. Under Section 72(5) of the Act it is a defence for an employing authority to prove that it took such steps as were reasonably practicable to prevent the act or omission of employees that breached the Code.
Both public and private hospitals are also subject to the duties imposed on health care providers by the Code of Health and Disability Services Consumers’ Rights, in particular, the duty to provide services with “reasonable care and skill” (Right 4(1)).
A hospital employing surgeons has an obligation to maintain and monitor their competence, to protect patients. This duty is recognised by statute and the common law.
Section 11(3) of the Health and Disability Services Act 1993 provided that it was an objective of every hospital and health service to exhibit a sense of social responsibility by having regard to the interests of the community in which it operates (section 11(3)(a)), and to uphold the ethical and quality standards generally expected of providers of health or disability services (section 11(3)(b)).
The Health and Disability Services Act 1993 was repealed from 1 January 2001, and replaced by the New Zealand Public Health and Disability Act 2000 (the NZPHDA), which established District Health Boards. Section 23(1)(i) of the NZPHDA provides that for the purpose of pursuing its objectives, each District Health Board (your responsible role as board members) must, as one of its functions, monitor the delivery and performance of services by it and by persons engaged by it to provide or arrange for the provision of services. The NZPHDA also provides that it is an objective of every District Health Board to improve, promote, and protect the health of people and communities (section 22(1)(a)), to exhibit a sense of social responsibility by having regard to the interests of the people to whom it provides, or for whom it arranges the provision of, services (section 22(1)(g)), and to uphold the ethical and quality standards commonly expected of providers of services and of public sector organisations (section 22(1)(i)).
The NZ Medical Council also supports culpability for medical malpractice
The following is an extract from on the current Code of Ethics from the New Zealand Medical Association records:
“Doctors should ensure that patients are involved within the limits of their capacities, in understanding the nature of their problems, the range of possible solutions, as well as the likely benefits, risks, and costs, and shall assist them in making informed choices”.
A ruling of the High Court of Australia, their highest appellate court, was very similar to the standards, which the New Zealand Medical Council has enunciated:
“….that a doctor has a duty to warn a patient of a material risk inherent in the proposed treatment: a risk is material if, in the circumstances of the particular case, a reasonable person in the patient’s position, if warned of the risk, would be likely to attach significance to it or if the medical practitioner is or should reasonably be aware that the particular patient, warned of the risk, would be likely to attach significance to it.”
The High Court of New Zealand B v The Medical Council of New Zealand
According to the Medical Council of New Zealand the definition of malpractice is: “involving immoral, illegal or unethical conduct or neglect of professional duty (improper professional conduct).”
“If it can be shown that a doctor has failed to provide adequate information and thereby failed to ensure that the patient comprehends, so far as is possible, the factors required to make decisions about medical procedures, such failure could be considered medical misconduct and could be the subject of disciplinary proceedings.”
And according to expert opinion on patient rights “the doctor who deliberately harms patients could be considered a criminal. Where a health practitioner kills a patient by reckless acts or omissions, a manslaughter prosecution may be warranted”.
Negligence generally involves a breach of a medical practitioner’s duty in their professional setting. If a medical practitioner is negligent and bringing harm to the reputation of the profession it requires an objective assessment of whether reasonable members of the public, informed and with knowledge of all the factual circumstances, could reasonably conclude that the reputation and good standing of the profession was lowered, by the behaviour of the medical practitioner concerned. The threshold test recognises that not all acts or omissions that constitute a failure to adhere to the standards expected of a medical practitioner will constitute professional misconduct.
The onus is on DHB’s to monitor responsibilities and duties imposed on health care providers
All DHB’s should take immediate steps to investigate whether medical malpractice fraud is happening in your surgical departments.
- Were patients provided with the opportunity to legally give informed consent? Patients, past and present, who have undergone cholecystectomy treatment of gallstones should be interviewed to gather full information of the situation in your district. Patients should be routinely asked:
- Were cholecystectomy patients advised of the side effect risks of a heterogeneous group of diseases and symptoms presenting following the gallbladder’s removal?
- Were cholecystectomy patients offered non-surgical alternative treatment options?
- Has post-treatment care support and information been provided to patients to help mitigate, diagnose and treat side effect risks, in order to minimise the potential harm, and optimise quality of life?
Note: It also displays an immoral, unethical and illegal intent to inflict patients with a heterogeneous group of diseases and symptoms presenting following gallbladder removal. Under Section 201, of Crimes Act 1961 this is identified as infecting with disease, and everyone is liable to imprisonment for a term not exceeding 14 years who, wilfully and without lawful justification (patient consent obtained illegally), or excuse, causes or produces in any other person any disease or sickness.
- Meet with experienced Gastroenterologists and ask of them, “Who is telling the truth about long-term risks? What information offers informed consent?” Research into what is a misrepresentation of the truth. DHB’s should ask: “Has the rights of patients been upheld to receive information on the risks of treatment and the opportunity to give informed consent?”
- Simply, meet with an experienced Naturopathic physician and seek out their opinions on the current state of cholecystectomy patients seeking support. A misrepresentation of the side effect risks and alternative treatment options has led to patients’ seeking the help of naturopaths and alternative medicine.
- Services may be provided to a consumer only if that consumer makes an informed choice and gives informed consent, except where any enactment, or the common law, or any other provision of the Code of Rights provides otherwise. Without this information, patients are denied that opportunity to legally give informed consent.
Final questions to be asked of DHB Board Members
What kind of moral and ethical medical practitioner, service provider, or administrator would openly facilitate medical treatment on patients, without telling the truth about the risks of injury or side effects, in order to maintain the deception and prevent post-care treatment support? There is even a systemic failure by these bodies to acknowledge treatment has caused harm in the first place.
Every consumer has the right to have services provided both legally and ethically in a manner that minimises the potential harm to, and optimises the quality of life of, that consumer – Code of Rights, Right 4 (4).
Previous evidence-based medical studies
Previous evidence-based medical studies show that current laparoscopic cholecystectomy procedures display a failure to act by multiple parties (including DHBs) and is an intent to commit harm to patients.
There is not a single long-term medical study anywhere in the world, carried out on patients, that backs medical opinions presented to health consumers by New Zealand surgeons (employees of DHB’s). The opinions of these surgeons could be considered a revenue-based fantasy.
Comprehensive and reputable medical studies confirm:
The Postcholecystectomy Syndrome (PCS): is a heterogeneous group of diseases and symptoms presenting following gallbladder removal. Symptoms occur in about 5 to 40 percent of patients who undergo cholecystectomy, and can be transient, persistent or lifelong. The chronic condition is diagnosed in approximately 10% of postcholecystectomy cases.
Post-cholecystectomy Syndrome may include:
- Diarrhoeaas a troublesome problem range from 9 to 12% of which bile acid malabsorption(BAM) , 65% of these patients.
- Depression, anxiety disordersoccurring in 0.9%-3.0% of patients
- Bile (duodenogastric) refluxoccurring in 20%-30% of patients. Likely damage attributable to chronic bile exposure post-cholecystectomy includes:
- cellular damage to esophagogastric junction
- bile induced Gastroesophageal Mucosal Injury (Protective barrier that constrains the acidic reflux)
- increase the incidence of gastric and esophageal cancer
- Sphincter of Oddi dysfunction (SOD) is seen in 1% of patients after cholecystectomy, but in 14%-23% of patients with the post-cholecystectomy syndrome
- increased Body Mass Index (weight gain) with metabolic syndrome, gastritis, liposoluble vitamin deficiency. Cholecystectomy can have nutritional and metabolic consequences and in the long-term
The cholecyst sphincter of Oddi reflex, cholecyst-antral reflex, and cholecyst-oesophagal reflexes are all disrupted and some local upper gastrointestinal hormonal changes also occur after cholecystectomy. Thus, there is an increased incidence of gastritis, alkaline duodene gastric reflux and gastro-oesophageal reflux after cholecystectomy, all of which may be the basis for postcholecystectomy symptoms.”
The onset of symptoms may range from 2 days to 25 years. There may also be gender-specific risk factors for developing symptoms after cholecystectomy. In one study, the incidence of recurrent symptoms among female patients was 43%, compared to 28% of male patients.”
This Email, or letter, has been sent in accordance with the Health and Disability Advocacy Code of Practice, requiring health consumers, in order to receive informed consent and medical support services, to take their own direct action to improve health and disability services.