Decision report 201101254

Summary
In late 2005, tests revealed that Mr C had elevated liver function tests and he was advised to reduce his alcohol consumption. Mr C's liver function tests became significantly elevated in 2007 and his GP believed that these were consistent with his alcohol history, a view supported by hospital specialists. In 2010, following tests, a hospital specialist diagnosed hepatitis C.

Mr C complained that his GP did not look beyond alcohol misuse as the cause of the abnormal results and that he should have been screened for hepatitis C much earlier. He said that as a result of the failure to do so, he began treatment at an advanced stage of the disease which had impacted adversely on his chances of surviving.

We found that the GP failed to fully investigate Mr C's liver functions abnormalities, particularly in 2007. Although it was impossible to say definitively whether Mr C would have tested positive for hepatitis C earlier than 2010, we found that it was possible he might have and, therefore, an opportunity to make an earlier diagnosis was missed and treatment was potentially delayed.

Recommendations
We recommended that the practice:
• review its management of liver function abnormalities including information provided in referrals; and
• apologise to Mr C for the failures identified.