A Dunedin doctor injected a thick vaccine into a 6-week-old's leg, but it was supposed to be given orally.

A Dunedin doctor is facing scrutiny after bungling a 6-week-old baby's immunisations by injecting a thick oral vaccine into his leg.

When the baby's mother sought a copy of the medical notes, she found Dr Kumud Dunn had also apparently billed health providers for supposedly treating her too – with notes referring to a "sexual health" check that did not take place and containing incorrect details.

Toni Paul took her son, Tanga Webster, for his routine immunisations at Dunedin's Gardens Medical Centre, where Dunn is a partner, on February 5.

Hamish McNeilly/Stuff Dr Kumud Dunn, of the Gardens Medical Centre in Dunedin, administered an unknown vaccine to a six-week-old baby, with the concerned mother raising further allegations against the doctor.

Instead of a nurse, Dunn measured the baby's head circumference and weight but failed to check his hips, and proceeded with three injections.

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The vaccines included the rotavirus vaccine, which is supposed to be administered orally.

Hamish McNeilly/Stuff Toni Paul, Isaac Webster and Tanga Webster in their Dunedin home.

"She assured me that is how they are doing it these days," Paul, whose other children were vaccinated in Australia, said.

"He was given two jabs in the left leg, and one in the right."

The rotavirus was recorded in the baby's Well Child book, and signed by Dunn, as being injected in the boy's left leg. Paul's partner, Isaac Webster, was at the appointment.

Hamish McNeilly/Stuff Vaccines recorded for a 6-week-old baby.

Paul said Dunn called and advised Tanga needed a vaccine "top-up".

It is understood alarm bells at the clinic started after an audit discovered an extra vial of medication.

It would transpire that, as well as being injected with the oral vaccine, the baby had not received one component of the Infanrix hexa, a combination vaccine that protects infants from six diseases.

Dunn, in her clinic notes, recorded she had "explained to the mother – she was very gracious – apologised for the hassle I have casued her [sic]".

But Paul said she was not gracious, admitting "I swore at her", and that Dunn did not apologise.

An "immunisation review meeting" was called between the clinic's medical staff, Paul, her support person and an immunisation coordinator on February 18.

MARION VAN DIJK The Rotavirus vaccine is administered orally - usually by a qualified nurse.

Clinic notes show Dunn told the group she administered vaccines for a decade in the United Kingdom, where they were always given by a doctor rather than a qualified practice nurse, which is the norm in New Zealand.

The notes say Dunn was "very vague and unclear" what she gave the baby on February 5.

Dunn's own notes from the initial appointment differed to what was recorded in the Well Child book, saying she did administer the rotavirus orally. But she recorded in later clinic notes that original entry was "not correct".

It also noted Dunn lodged a report to the Centre for Adverse Reactions Monitoring, about two weeks after the incident.

"I haven't received a copy of that," Paul said.

Tanga's case was escalated to a private paediatrician, who lodged an official complaint with authorities. A claim has been lodged with ACC in case of any long-term health implications.

Paul said after the vaccines her baby had been unsettled and had large bruising on his hip and thigh, which her other children did not get from vaccines.

An ACC referral form, filled out by another doctor at the clinic two weeks after the vaccine bungle, said Tanga was "administered oral vaccination intramuscularly", causing bruising to his hip and thigh.

An Immunisation Advisory Centre spokesman confirmed "vaccine administration errors are a relatively rare event".

Authorised vaccinators undergo training and regular updates. "There are clear protocols, checks and balances, to ensure that all patients are given the right vaccine in the right manner", he said.

General practitioners (GPs) can give vaccines without any additional training, but would be expected to know how to give these in a safe and appropriate manner, he said.

The oral rotavirus vaccine comes in either a squeezable tube or an oral applicator – a syringe type applicator with a plunger stopper, which cannot have a needle attached to it.

Nearly three weeks after the incident, Paul is still angry. She had lost trust, she said.

"I just want to know the side-effects for my son."

MYSTERIOUS CONSULTATION

Paul said when she first took Tanga for his vaccination she was encouraged to register at the medical centre.

However, she was shocked to later find out that the doctor had recorded a supposed "consult in surgery" with her the same day. Dr Dunn's clinical notes include incorrect details about Paul's lifestyle, including that she drank and did not smoke.

It also noted a mysterious "sexual health claim".

It's understood GPs are funded for sexual health appointments by WellSouth (the primary health organisation for Otago and Southland), while postnatal consultations are funded by the Ministry of Health.

Dunn is since understood to have reversed those funding claims, citing an error was made, after Stuff made inquiries.

When approached for comment at her St Clair home last Thursday, Dunn denied knowledge of the vaccination bungle and declined to comment further.

She referred all comment to the medical centre.

In an emailed statement she confirmed she would respond to a complaint from the family, and "it is not my practice to debate these issues in the media".

She declined to answer specific questions other than to say "I have taken advice from appropriate sources to confirm that no risk of harm arose as a consequence of the immunisations to the patient".

DOCTOR SUSPENDED IN UK

In 2011, Dunn was suspended by medical authorities in the United Kingdom for embellishing her qualifications.

She claimed to be a Member of the Royal College of Physicians, and held a science degree when she had neither.

During the General Medical Council (GMC) investigation, Dunn allegedly tried to access a secure appraisal system so she could remove evidence of the false declarations.

"The 2011 Panel considered that your actions in all these respects amounted to a serious departure from the standards expected of a medical practitioner and that, despite positive evidence of your worth as a GP, it could not disregard the fact that you had acted dishonestly over a significant period of time," the decision noted.

At the end of her suspension period the GMC asked Dunn to provide evidence that she had further developed insight into her misconduct.

A medical colleague, in a letter to the GMC, said Dunn had shown "insight and remorse" regarding her dishonesty and had used her suspension to become a better doctor.

The GMC noted her remorse and that she was "a hard working and competent doctor".

"The Panel is satisfied that clear, quantifiable and persuasive evidence has been provided today which shows the steps you have taken to maintain and further your professional development and to plan for your return to practice.

"The Panel has no concerns that you present any risk to patient safety."

Her one-year registration suspension ended in August 2012. Local UK media called her a "dishonest" and "lying" doctor.

Dunn declined to comment about that suspension.

She later moved to New Zealand with her husband, and was registered as a medical practitioner by the New Zealand Medical Council on May 12, 2015.

The Medical Council, which registers doctors, said anyone with concerns about a health and disability service could contact the Health and Disability Commissioner or report any concerns anonymously to the Health Integrity Line on 0800 424 888.



WellSouth would not discuss individuals or specific practices, but its chief executive Andrew Swanson-Dobbs said if it received a complaint from a patient, clinician or agency it would investigate.

"WellSouth has systems in place to manage providers claiming payment for services, including ongoing monitoring and routine and regular audits," he said.

Do you know more? Email hamish.mcneilly@stuff.co.nz