Surgeon Barred for Six Months Over Cancer Misdiagnosis and Wrong-Site Surgery

A surgeon has been found guilty of professional misconduct and barred from practising medicine for six months after she failed to detect cancer in one patient and operated on the wrong end of the bowel of another.

The New South Wales civil and administrative tribunal considered the treatment of 13 patients by Dr Liu-Ming Schmidt, finding her management of them fell significantly below reasonable standards.

The tribunal found Schmidt “made a catastrophic error” when she operated on the wrong end of a 79-year-old man’s bowel. He had been transferred to Albury hospital in December 2019, and was found through a CT scan to have a perforated bowel, requiring a section of the bowel to be removed.

He also needed a stoma, where an opening on the abdomen is created by the surgeon so a colostomy bag can be connected for waste removal.

Schmidt “brought out the wrong end of the bowel when she formed the stoma,” the tribunal decision said. “She caused a complete mechanical bowel obstruction so that the stoma was not capable of passing faecal material.”

The tribunal found Schmidt’s “conduct of the procedure was significantly below the relevant standard”.

A coronial inquest into the 79-year-old’s death, referred to in the tribunal’s decision, found he died as a result of complications of inflammation, which was contributed to by the surgical error made by Schmidt.

“Other contributing causes to his physical decline and death included the prolonged delay in diagnosis of a mechanical bowel obstruction together with underlying natural causes,” the decision said.

The tribunal found Schmidt also failed to provide the man with appropriate post-operative care.

In another patient, Schmidt failed to perform a complete colonoscopy and because of this, did not detect a cancer that the tribunal found should have been identified during the procedure.

During the hearing, Schmidt said she had addressed the concerns raised and had engaged in self-reflection, further education, re-certification and education from peers.

“She has maintained and developed professional relationships and is constantly auditing, reflecting, analysing and discussing her performance,” the tribunal decision said.

The tribunal heard there were five patients where Schmidt failed to take the adequate time to perform colonoscopies. The procedure in one patient was finished in five minutes. Schmidt admitted to the tribunal she did not take enough time for the procedures.

She also failed to adequately capture images during the procedure in several patients, the tribunal found.

An expert witness who reviewed the cases told the tribunal that his main concern regarding those patients was “the relatively rapid time taken by Dr Schmidt to conduct the colonoscopies”.

“A rapid withdrawal time, he said, will lead to lesions being missed,” the decision said. Lesions found during a colonoscopy may indicate cancer.

In 2023, an investigation was launched by the Health Care Complaints Commission (HCCC) and Medical Council of New South Wales after a panel of experts reviewed patients Schmidt had treated between 2018 and 2022.

At the time, almost 2,000 patients who received colonoscopies performed or supervised by Schmidt were told they may need to have their procedures repeated to ensure they do not have cancer.

The tribunal found that of these, about 1,000 underwent a repeat colonoscopy. Seven of them were diagnosed with cancer.

“No one has, nor could they, say that this was a result of a failure by Dr Schmidt to identify a problem with the original colonoscopy,” the decision said.

“However, Dr Schmidt’s explanation to us for doing colonoscopies in a much shorter time than the standard, is that, as a surgeon with 10 years’ experience, she has been doing colonoscopies in the way she was taught in her training. She says this is confirmed by being regularly reaccredited after submitting all of the relevant information to the authorities.

“We cannot accept this explanation. The evidence before us is to the effect that Dr Schmidt’s training would have informed her that she needed to take longer than she had been taking to do a colonoscopy to ensure thoroughness in checking for abnormalities.”

Dr Schmidt admitted to the tribunal that her conduct was sufficiently serious to justify suspension or cancellation of her registration.

Once her suspension expires, Schmidt will have a number of conditions on her registration, including being required to practise under supervision.