General Practice cases
G v Rashid (2002) - Delay in diagnosing temporal
arteritis - loss of sight in left eye - settlement £25,000
Mrs R (Mother & Administratrix of the Estate of C) v
Dr A (1) & Dr B (2) (2001) - 9 year old girl - delay
in diagnosing high grade Non-Hodgkins Lymphoma - patient died -
settlement £13,200
M v James (1992) - Delay in diagnosing subacute
bacterial endocarditis – severe disabilities – settlement
£350,000
V v Dr H & Forest Healthcare NHS Trust
(1998) - Delay in diagnosing pyelonephritis – severe
kidney infection – renal scarring – loss of kidney function –
settlement £25,000
Full case details
G v Rashid (2002)
On 21 January 2000, Mr G attended his GP’s surgery because he
had been experiencing pain around the jaw and temple with flashing
lights and intermittent blindness for a period of at least two
weeks. In addition Mr G had lost a significant amount of weight.
His GP said he could not find any abnormality. He was prescribed
painkillers and advised to tie a scarf tightly around his face
whilst eating.
On 26 January 2000, G telephoned NHS Direct complaining of
“trouble in his temple”. He was advised to return to his GP. On 28
January, G visited his GP and explained that his symptoms had
worsened. He was unable to eat and was now experiencing deafness.
He was prescribed eardrops.
On 9 February G was still unwell and his GP visited him at home.
G requested a letter of referral to a specialist and after much
discussion the GP asked G to visit thesurgery the following day to
collect a referral letter, even though G said that he was not well
enough to attend the GP surgery. On 17 February G managed to visit
his GP’s surgery.
However, the letter of referral had not been written. On 18
February G visited his GP and demanded the letter of referral and
an urgent referral was made to the eye department at St Thomas’
Hospital. He was immediately hospitalised and remained an
in-patient for six days. A diagnosis of temporal arteritis was
made. He underwent a temporal artery biopsy under local anaesthetic
on 20 February. Even with the introduction of steroids G has not
regained his vision in his left eye but his other symptoms have
resolved. He was discharged home from St Thomas’ Hospital on 23
February and attended outpatients’ appointments thereafter. Mr G
instructed FFW in November 2000.
The case was conducted under a “no win, no fee” agreement.
Proceedings were issued on 12 June 2002. Following negotiation, the
claim settled in the sum of £25,000.
Mrs R (Mother & Administratrix of the Estate of C) v Dr A
(1) & Dr B (2) (2001)
On 2 December 1998, C, a nine-and-a-half year-old girl, attended
her GP surgery complaining of loss of appetite, loss of weight,
difficulty sleeping, constipation and a distended stomach. She was
seen by Dr B who diagnosed constipation and prescribed latulose
solution. On 8 December 1998, C attended her GP again complaining
of diarrhoea and passing blood. Dr A advised that C should stop
taking the latulose and instead prescribed oral rehydration powder.
On 15 December 1998, C attended Dr A complaining of feeling unwell
with a distended tummy which was hard to the touch. Dr A advised R
that C should be given plenty to drink. On 13 January 1999, C
attended Dr A who found a hard mass in her stomach and referred her
to hospital. Unfortunately, C’s condition deteriorated and she died
later that night.
Post mortem examination confirmed marked distension of the
abdomen and revealed a large mass due to a high grade Non-Hodgkins
Lymphoma.
Our expert criticised the failure of Dr A and Dr B to examine C
during December 1998 and refer her to hospital for investigations.
A paediatric oncology expert confirmed that it was likely that the
tumour was palpable on 2 December 1998. Had treatment been given in
early December 1998, there would have been 75% to 80% chance of a
cure.
In response to the letter of claim Dr A admitted that he had not
carried out an abdominal examination on 8 December, but stated that
this was because her history did not warrant it.
FFW were instructed to act on Mrs R’s behalf. In the meantime,
the GMC found that Dr A’s conduct in relation to his care of C
“fell seriously short of the standard expected of doctors” and
considered that he was guilty of serious professional misconduct.
The GMC also warned Dr B about his conduct in relation to his
treatment of C, particularly in relation to keeping clear records
and taking more care when examining children. Following
negotiations, the claim was settled on 15 May 2001 in the sum of
£13,200.
V v Dr H & Forest Healthcare NHS Trust
(1998)
V was suffering from dizziness and low back pain, vomiting,
fever and was shivering vigorously. She was seen by a deputising GP
on two occasions and was told that she had flu. She did not improve
and called her own GP two days later, who arranged emergency
admission to Whipps Cross Hospital. Initial investigations
indicated pyelonephtritis, but the surgeons proceeded to perform a
laparotomy to exclude appendicitis and sepsis. They also failed to
institute antibiotics until the day after V’s admission. Had V been
admitted to hospital two days earlier and treated correctly, she
would not have suffered such a severe kidney infection, renal
scarring or loss of kidney function.
A settlement was agreed in the sum of £25,000, plus costs.
M v James (1992)
M attended her GP complaining of back pain, weight loss, night
sweats, tiredness, heart palpitations, severe headaches and aching
limbs. Sacro-iliac joint strain was diagnosed. About a month later,
M re-attended with the same complaints. Her GP referred her to St.
Helier Hospital for a chest x-ray and urine test. Two weeks later,
the GP reported to M that these were clear and prescribed an
antibiotic (for a virus). M’s symptoms persisted and a month later,
her foot became numb with swelling around her left ankle. The GP
again referred her for more x-rays, but this time made a diagnosis
of post natal depression. M returned to her GP one month later,
reporting the same symptoms. The GP repeated the diagnosis of
post-natal depression and an anti-depressant was prescribed. Three
weeks later, M woke up with a loss of right-sided vision. Her GP
noted visual defect, paraesthesia in her right hand and a collapse
the previous day. An abnormal blood pressure and pulse rate were
recorded and abnormalities to the CNS were seen. M was admitted
immediately to hospital and a diagnosis of subacute bacterial
endocarditis was made. As a result of the six month delay in
diagnosing the illness, M has been left with very severe
disabilities and was no longer able to work or drive.
A settlement was agreed in the sum of £350,000, plus costs.