Decision Report 201301919

Summary

Ms C said she had suffered back pain since about 2006 but had only managed to get her GP (with whom she had been since 2008) to send her for a bone scan in 2013. She said she could not be specific about dates as she could not remember them exactly but about three years ago she had collapsed in the street, and had difficulty walking. She said she was in considerable pain and asked to have her back x-rayed, but the GP refused. When Ms C was later referred for a bone scan she was very upset to be told that she had four fractures in her back.

We took independent advice from one of our medical advisers, who considered Ms C's medical records, and said that the GPs in the practice had made reasonable assessments of her back pain when she went to the surgery. Although we did not uphold her complaint about delay in referring her for a scan, our adviser also said that it was possible for a GP to order a lumbar spine x-ray if a worrying cause of back pain is suspected, and that the GP had misinterpreted the findings of the bone scan, so we made recommendations.

Recommendations

We recommended that the practice:

• ensure that all GPs note that it is possible for a GP to order a lumbar spine x-ray if a worrying cause of back pain is suspected;
• update Ms C's records to accurately reflect that she has four osteoporotic fractures in her spine and take the opportunity to re-evaluate her pain management given this information; and
• apologise to Ms C for the misinformation concerning whether or not she has four fractures and that a GP cannot refer a patient directly for a spinal x-ray.