Decision report 201200574

Summary

Mrs C complained that her former GP did not investigate the symptoms she was reporting, and that this led to a delay in a spinal problem being diagnosed and treated. Mrs C had a complex medical history with various symptoms which she reported at various consultations at the medical practice, as well as during home visits and phone consultations. She was being treated for various medical conditions, some of which had symptoms that related to her spinal problem.

Our investigation, which included taking independent advice from one of our medical advisers, found that it was reasonable that the practice did not specifically investigate the possibility of a spinal problem. The adviser was of the view that many NHS GPs would have had difficulty in identifying or suspecting a spinal problem in the midst of the many and complex conditions from which Mrs C suffered. The adviser also noted that the first mention of a symptom that could specifically have related to a spinal problem, and which could have been followed-up, took place at a consultation at the practice in April 2012, which lasted for an hour. During the consultation, Mrs C had taken exception to a suggestion by the GP for a referral to another specialist, unrelated to the spinal problem. She had left the consultation and four days later made a formal complaint to the practice. In her letter she indicated that she and her husband no longer wished to be patients there.

The practice had reviewed Mrs C's complaint letter, and as they felt that the doctor/patient relationship had broken down, had applied to the local health board to have Mr and Mrs C allocated to another practice, which happened in early May. By the middle of June, Mrs C's new GP had ordered a MRI (a specialist type of imaging) scan, which revealed the spinal problem. Our investigation found that, in the circumstances, it was not unreasonable that the original practice did not follow up the specific symptom reported in April 2012.