Source · SPSO (Scottish Public Services Ombudsman)

A Medical Practice, Highland NHS Board

SPSO (Scottish Public Services Ombudsman) Upheld Reference 201102356 Sector Health Category Clinical treatment / Diagnosis Decided 01 January 2012

Full decision

Summary

Mrs C attended her GP in January 2010 complaining of abdominal pain. She complained that from then until November 2010 when she was diagnosed as having intra-abdominal cancer, her GP practice failed to either act upon her symptoms or treat them appropriately.

Our clinical adviser found that Mrs C had significant, persistent symptoms which appeared to become worse despite a number of medications related to the gastrointestinal tract. In the adviser's view, this should have prompted a review of the diagnosis especially in the presence of a normal upper abdominal ultrasound and normal endoscopy and sigmoidoscopy (a procedure used to see inside the sigmoid colon and rectum). The adviser added that Mrs C's communications with the practice were clear and concise and that her requests for assistance were specific. Accordingly, the adviser concluded that the management of Mrs C was deficient and we upheld the complaint.

Recommendations

We recommended that the practice: • formally apologise to Mrs C for their oversights in her management and perform a Significant Event Audit; and • ensure that the GP discusses this case at their next appraisal.

Related reading

View Decision Report 201102356 as a PDF (18.73 KB) Updated: March 13, 2018

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