Decision report 201200871

Summary

Mr C had a left knee and hip replacement several years ago. He attended the hospital's orthopaedic clinic (clinic for conditions involving the musculoskeletal system) around a year ago because he continued to have pain in his left leg and difficulty walking. He was discharged from the clinic, but was diagnosed around a year later with neuro-sarcoidosis (a chronic disease of unknown origin characterised by the enlargement of lymph nodes in many parts of the body along with nerve tissue dysfunction). Mr C complained that, despite his ongoing pain and difficulty walking, the orthopaedic consultant discharged him from the clinic without referring him to a neurologist (a specialist in the science of the nerves and the nervous system, especially of the diseases affecting them).

After taking independent advice from one of our medical advisers, we found that there was evidence that the consultant carried out appropriate assessments to test Mr C's reflexes and there was no clear indication of a neurological abnormality. Referral to a neurologist would not, therefore, have been necessary at that time. In addition, we considered that it was reasonable for them to have discharged Mr C, as it was not unusual for a man of Mr C's age to experience unsteadiness following knee and hip operations.