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Case ref:202003052
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Date:November 2021
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Body:Tayside NHS Board
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Sector:Health
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Outcome:Upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
C had been treated for chlamydia and gonorrhoea (two types of sexually transmitted infection) by the board. C continued to feel unwell and attended an appointment at the board. C was concerned that they were not physically examined or tested for pelvic inflammatory disease (an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries) and that they were advised to isolate with a possible COVID-19 infection.
We took independent advice from a consultant in sexual and reproductive health with a background in hospital gynaecology (female reproductive system). We found that C reported symptoms which were consistent with pelvic inflammatory disease. In the circumstances, it was unreasonable that a physical assessment was not performed, or as an alternative, empirical antibiotic therapy commenced for possible pelvic inflammatory disease. It was unreasonable that further steps were not taken to assess for and exclude pelvic inflammatory disease as a possible diagnosis in this case, prior to providing the advice regarding self-isolation for possible COVID-19 infection.
In light of the above, we upheld C’s complaint.
Recommendations
What we asked the organisation to do in this case:
- Apologise to C for not performing a physical assessment for pelvic inflammatory disease or as an alternative commencing empirical antibiotic therapy. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.
What we said should change to put things right in future:
- Patients who present with abdominal pain and fever, in the context of a recent sexually transmitted infection, should be physically examined and/or commenced on empirical antibiotic therapy.
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.