Decision report 201103773

Summary

Mrs C had a method of contraception, an intrauterine device (IUD), fitted by a doctor in March 2010. She subsequently developed symptoms including abdominal pain, bleeding and difficulty with bowel movements. Mrs C attended the practice three days later and was prescribed antibiotics for a possible infection following the fitting. In June 2010, Mrs C found out that she was pregnant. After her baby was born, she had surgery to have the IUD removed. It was found to have caused internal damage and to have moved.

Mrs C complained that the doctor had not taken reasonable care when fitting the IUD and did not properly investigate her symptoms. Although we were unable to assess the procedure, we found that Mrs C’s medical notes were comprehensive and detailed, and that the doctor had undergone suitable update training and fitted an appropriate number of IUDs per year. We also noted that Mrs C had undergone IUD counselling before having the device fitted, where she had been told about the risks, including the risk of internal damage. Although this was a rare complication, the fact it had occurred did not mean the doctor had not carried out the procedure with reasonable care, so we did not uphold this complaint.

We also found that the practice carried out reasonable investigations of Mrs C’s symptoms. They examined her at three appointments and located the threads of the device. Guidance states if these threads can be seen and felt then it can be assumed the IUD is in the correct place. When Mrs C attended a second appointment after the fitting, she said that the symptoms had resolved so we found it was reasonable that the practice did not undertake further investigations. We also found that the practice would not have been expected to arrange an ultrasound scan to confirm the positioning of the IUD, as this is not recommended by guidelines.