Decision Report 201302420

Summary

Mr C experienced dizziness and balance problems after an operation on his ear in 2007. In 2012 he was referred to Glasgow Royal Infirmary's ear nose and throat (ENT) department. After examining Mr C, the ENT consultant wrote to the GP saying that he could find no physical cause of Mr C's symptoms. He referred Mr C to the Royal Alexandra Hospital for specialist tests, but commented that he felt some of Mr C's symptoms were not genuine. The specialist tests identified that Mr C had an almost complete loss of vestibular function (the system in the ear that contributes towards balance) in his left ear. Mr C complained that the ENT consultant in the first hospital did not carry out appropriate diagnostic tests or provide suitable treatment for his condition. He also complained that the second hospital did not keep his GP adequately informed of the tests that he was undergoing or his diagnosis.

We took independent advice from one of our medical advisers, who is a consultant ENT surgeon. Although we were critical of the ENT consultant's comments in his letter to Mr C's GP, we were generally satisfied that he assessed Mr C's condition appropriately and made a suitable referral for specialist treatment. That said, we took the view that he could have given more consideration to the need for a magnetic resonance imaging scan (used to diagnose health conditions that affect organs, tissue and bone), and the potential effects of Mr C's existing medication. We were satisfied that Mr C's GP was provided with adequate information about the investigations into his symptoms and his ongoing treatment.

Recommendations

We recommended that the board:

• apologise to Mr C for the ENT consultant's suggestion that his symptoms were not genuine; and
• share our decision with the ENT consultant with a view to identifying any points of learning.