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Case ref:201304348
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Date:September 2014
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Body:A Medical Practice in the Highland NHS Board area
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
Mrs C has a complex medical history. She told us that because she had been experiencing extreme pain in her feet (to the extent that she could not walk) she needed to contact her medical practice on a number of occasions. She complained about a lack of support from the GPs at the practice. In particular, she said that, despite telling a GP that tramadol (a drug used to treat moderate to moderately severe pain) did not work for her, he continued to prescribe it. Another GP refused her a dosette box (a pill organiser that helps people on multiple medications to take these at the right time) and prescribed an anti-inflammatory gel, which she said the pain clinic she had previously attended had told her not to use. Mrs C said that both GPs left her without support and in great pain.
We obtained independent advice from one of our medical advisers, who is a GP. After taking all the relevant information into account, including the complaints correspondence and Mrs C's medical records, we did not uphold Mrs C's complaints. We found that she was previously prescribed tramadol for chronic pain, and the new, acute pain she was experiencing had a different cause. Our adviser said that this pain might respond differently to tramadol, so the prescription was not unreasonable. Similarly, an anti-inflammatory gel could be used safely where anti-inflammatory tablets could not. Although Mrs C wanted a dosette box, we found that she did not qualify for this under the health board's criteria.