Decision Report 201507646

Summary

Mrs C, who works for an advice agency, complained to us on behalf of Miss A. Miss A had attended her medical practice after falling over on her ankle. Her appointment was made by her pharmacist, who thought Miss A might have a deep vein thrombosis (DVT, a blood clot in the vein). Miss A was examined by a doctor, who diagnosed a calf strain. She was advised to take pain relief.

However, Miss A's pain continued and she attended A&E on a number of occasions, where she was diagnosed with a fractured ankle. Miss A continued to report problems and was subsequently referred to a vascular surgeon (a surgeon who treats disorders of the circulatory system). A DVT was found and Miss A was required to have her leg amputated below the knee.

Mrs C complained to us that the practice failed to appropriately diagnose and treat Miss A and about the way they dealt with Miss A's subsequent complaint.

We took independent advice from a GP. They found that Miss A's diagnosis had not been unreasonable, that she had been appropriately examined and that her circulation was reasonably assessed. They also found that Miss A's complaint received a reasonable reply. We therefore did not uphold Mrs C's complaints. However, the adviser noted that Miss A's GP had not been alert to Miss A's early signs of PVD (peripheral vascular disease, or peripheral arterial disease (PAD)) which should have been followed up. We therefore made recommendations to address this.

Recommendations

We recommended that the practice:

• ensure that the GP familiarises themselves with the diagnosis and management of patients presenting with early PVD and discusses this at their next yearly appraisal; and
• takes steps to ensure that they are familiar with the presenting signs of PAD and its management.