The Supreme Court of Victoria has found in favour of a busy GP who failed to follow up a patient who did not return as advised for Q fever vaccination and later developed the condition.
Stephen Grinham was working at the Tabro Meats abattoir in Gippsland when he contracted Q fever in early 2006 — a bacterial infection causing high fever, rigors, lethargy and profuse sweating.
He now has post-Q fever syndrome, involving prolonged symptoms of the same condition, which has incapacitated him for work.
In 2002, soon after starting work at the abattoir, Mr Grinham consulted Dr Catherine Murray, then a GP registrar, to be immunised against the infection. The vaccine would have provided him with lifelong protection.
But as Mr Grinham’s pathology revealed a low positive result for the infection — now recognised as a false positive — Dr Murray told him he should not be vaccinated.
This was consistent with guidelines, which warn of potential hypersensitivity reactions in patients with positive Q-fever antibodies.
Dr Murray asked Mr Grinham to re-attend in a month’s time after further serological testing. But Mr Grinham did not have the tests and did not re-attend .In 2006 was struck down by the infection.
Earlier this year Mr Grinham successfully claimed damages from Tabro Meats.
The company and the Victorian Workcover Authority launched separate proceedings against Dr Murray.
The dispute centred on whether Dr Murray ought to have given better advice to Mr Grinham about the seriousness of the situation, and to have recalled him when he did not attend up as advised.
The Supreme Court of Victoria was told that abattoir workers were at high risk of Q fever — caused by a highly contagious organism found within domestic herds, which can lead to human infection via aerosol transmission.
The court heard Mr Grinham spent most days sorting through the body parts and internal organs of slaughtered cattle. Tabro provided him with gumboots, gloves and a hair net, but he was not provided with any type of mask or face protection.
Justice Jack Forrest said on Tuesday in his opinion it was “unnecessary [for Dr Murray] to tell Mr Grinham that he remained at risk for Q-fever infection whilst he continued to work at the abattoir — he knew he was at risk and this activated his attendance at the clinic”.
“I am not satisfied that even if advice was given in stronger terms ... that it would have resulted in any different result.”
He also said it was reasonable for Dr Murray not to have implemented a recall of Mr Grinham, saying: “She fully expected [him] to return to the clinic having undergone the pathology test, as requested. This was neither unrealistic nor hopeful.”
He concluded that Dr Murray was not negligent in providing advice or in failing to recall Mr Grinham.
He dismissed the claims of both Mr Grinham and the Victorian Workcover Authority.