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Case ref:201608559
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Date:May 2018
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Body:A Medical Practice in the Lothian NHS Board area
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Sector:Health
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Outcome:Some upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Mrs C complained that the practice failed to provide appropriate care and treatment to her late husband (Mr A). Mr A, who had type 2 diabetes, had thought he was suffering from a urine infection but the practice dismissed the suggestion and did not provide medication. Mr A subsequently developed chest and back pain over the next week. A house visit was then requested early in the morning but it took until early evening for a GP to visit. The GP felt that Mr A required a hospital admission and an ambulance was called to take Mr A to hospital. He died the following day. Mrs C complained that the practice failed to diagnose that Mr A had a urine infection and that, on the day he was taken to hospital, there was an unreasonable delay in a GP making a home visit.
We took independent advice from an adviser in general practice medicine and found that the practice provided Mr A with reasonable treatment regarding his perceived urine infection. The practice carried out an appropriate assessment, including testing for a urine infection, which was reported as negative. Therefore, we did not uphold this aspect of Mrs C's complaint.
In relation to the home visit, we found that there was an unreasonable delay in arranging the home visit to Mr A as there was a breakdown in communication when the request for a home visit was considered. Initially, it was felt that an advanced nurse practitioner should visit but they felt that it was outwith their remit and there was a delay in the request being picked up by the GP. Therefore, we upheld this aspect of Mrs C's complaint.
Recommendations
What we asked the organisation to do in this case:
- Apologise to Mrs C for the delay in advising the duty doctor that a home visit had been requested. The apology should meet the standards set out in the SPSO guidelines on apology available at https://www.spso.org.uk/leaflets-and-guidance.
We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.