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- 13 November 2001
Ms Laura Leonoff Medical Treatment
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Page: 18421
The Hon. ALAN CORBETT [10.28 p.m.]: I wish to briefly relate the story of a woman who received a life-saving operation some 10 years ago but who has since suffered, and still today suffers enormously, from unintended consequences after follow-up surgery. In June 1991 Laura Leonoff collapsed with a blinding headache. Westmead Hospital diagnosed a subarachnoid haemorrhage. Emergency surgery was performed the next morning. A large bone flap from the right temple was removed for surgical access to Laura's brain. The bone was placed into cold storage for replacement at a later date, to allow surgical swelling time to go down—a fairly standard procedure.
The surgery went well: Laura's life was saved. The neurological signs rapidly returned to normal, although she had blindness in one eye plus neck and shoulder pain. When discharged Laura was told she must return in a few weeks for the follow-up bone flap replacement. It was another five weeks before Laura was readmitted as a public patient for the operation. The neurosurgeon who had performed the initial surgery in charge of the case was not recorded as being in the operating room, only registrars. Shortly after discharge Laura became anxious. The operative swelling had reduced and then a marked dent appeared on her skull, just as there had been before the bone replacement.
During the months of recovery Laura's jaw started to ache. She began chiropractic treatment for the neck and shoulder pain but was unable to continue due to the cost. There was no follow-up appointment with Laura's original surgeon after her first discharge. She had to wait a year to see a neurologist at Westmead who noted the obvious depression on the right temple and suggested that bone infusion would improve with time. No improvement appeared in the look of her skull as time past. Laura suffered from severe neck, shoulder and jaw pain. The local dentist found that the jaw was no longer well aligned and she had developed temporo-mandibular joint dysfunction on the right side. She was losing weight and having trouble sleeping.
Three years after the original surgery Laura saw a second neurologist, who noted a bony depression in her skull and told her it could be corrected surgically. He did not say what caused the depression. She was not inclined to have further surgery—it had been an unpleasant experience and she had been given no real reason to believe it was needed. Over the next three years a range of neurologists told Laura that her large facial defect was merely cosmetic and that the painful symptoms arising since her surgery were hysterical in origin and unrelated to the surgery. She was told repeatedly that she was neurologically normal and that she had normal reflexes.
Laura became very depressed and frustrated. After six years a Sydney-based United States-trained neurosurgeon told Laura that there was no bone over the surgery site despite the surgery having apparently replaced it. Meanwhile, Laura's original neurosurgeon reported to her general practitioner that she was not likely to need further surgical treatment and that she had no permanent impairment and should be capable of returning to work. This doctor admitted that he had not seen her since her first surgery in 1991. Yet Laura was still unable to work.
Members of the dental profession were confident that Laura's facial pain was related to the lack of bone for jaw muscle attachment, which caused her unstable jaw alignment, and that her neck pain was the result of head positioning during surgery. In early 1998 a discharging sore, which failed to heal, developed over the skull defect. Laura was referred to yet another neurosurgeon, who wanted to open the site, remove any dead tissue, treat her with antibiotics and later plate the defect. Laura refused surgery: she had become fearful of surgical outcomes in Australia because of a lack of information over so many years. Laura still has a weeping wound, despite long-term treatment with antibiotics.
Since 1999 Laura has contacted State and Federal politicians about her plight. The New South Wales Minister for Health referred Laura to the Health Care Complaints Commission, which organised a meeting between Laura and Western Sydney Area Health Service representatives—two neurosurgeons and an administrative officer—in August 1999. The meeting was not a success for Laura, although the doctors seemed satisfied: they dismissed her health problems as being unrelated to the surgery. The Health Care Complaints Commission decided that the case did not warrant further investigation. Laura approached the Independent Commission Against Corruption and the Ombudsman, who stated that it was not in their field. After 10 years, Laura has no avenues left to explore, which is why I have placed her story on the record. I ask the Minister for Health to re-examine this case urgently and compassionately, with a view to helping Laura Leonoff obtain treatment for her ongoing painful condition and assisting her in any other way possible.
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