An unnamed surgeon has been found to have breached patient rights by failing to ensure his seriously ill patient got emergency surgery quickly.
The case is detailed in a report released on Monday by Health and Disability Commissioner Anthony Hill.
The orthopaedic spinal surgeon operated on a 69-year-old doctor, who is not identified, in the unnamed private hospital in 2009 to ease her long-standing back pain.
By midnight on the day of the surgery, the patient had lost feeling and movement in both feet.
She needed emergency surgery for a serious neurological complication, but Mr Hill says the surgeon failed to tell others it was urgent, and follow-up surgery occurred later than it could have.
An unnamed nurse is faulted for failing to monitor and report changes in the woman's condition.
The patient was transferred to a public hospital, then a spinal unit. Mr Hill says the woman has since improved but is still in pain.
"My expectation is that the surgeon would have known that a theatre was needed to be made available urgently," Mr Hill says. "The key decision that he made that I'm very critical of was the decision not to arrange for a theatre as soon as possible in order to have this patient taken back to theatre.
"There is a lesson here that professionals need all of the professionals around them to be working optimally because that will ensure that the quality of service provided to their patients is safe and of a high quality."