Source · SPSO (Scottish Public Services Ombudsman)

A Medical Practice in the Forth Valley NHS Board area

SPSO (Scottish Public Services Ombudsman) Not Upheld Reference 201200987 Sector Health Category clinical treatment / diagnosis Decided 01 March 2013

Full decision

Summary

Miss C complained that GPs failed to carry out appropriate investigations into the symptoms her late mother (Mrs A) was presenting with from November 2010. Mrs A was diagnosed with lung cancer in May 2011 and died in August 2011. Before she was diagnosed, Mrs A had been treated and monitored for breathlessness which was not resolving with the treatment provided. The family told us that they felt that the GPs were treating Mrs A as if her symptoms were psychological and that as a result there was a delay in diagnosing the cancer.

When Mrs A (who was a smoker) first complained of breathlessness, various tests were carried out. Her chest x-ray and blood tests were reported as being normal. Mrs A continued to suffer breathlessness, however, and was reviewed regularly in the practice by the nurse. She was also seen by GPs and the out-of-hours service. In March 2011 Mrs A was diagnosed with a chest infection and prescribed antibiotics (drugs to treat bacterial infection). When the condition persisted, she was referred for a further chest x-ray. This x-ray was reported as abnormal and Mrs A was referred urgently for a CT scan (a special scan which uses a computer to produce an image of the body), after which she was diagnosed with lung cancer.

Our investigation, which included taking independent advice from a medical adviser, found that the care and treatment provided to Mrs A was reasonable, and in line with the national and local guidance on investigating, managing and treating lung cancer. Although Mrs A had been referred for counselling from the community psychiatric nurse, we found no evidence that the GPs considered Mrs A's symptoms were psychological. The adviser said that the GPs clearly took note of Mrs A's physical symptoms and investigated them in a reasonable and timely manner, and in line with national guidance.

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