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Case of the month

Page last updated on 30 January 2012

January 2012

Wait and see?

...contradictory claims over whether Mr L had reported vomiting while under treatment with oral antibiotics pose a significant risk...

December 2011

Weekly for daily

...The elderly woman is admitted to hospital with atrial fibrillation when doctors discover there has been a prescribing error...

November 2011

Lost and found

...Dr B suspected the data stick had gone missing a week before it was found but didn't report it...

October 2011

Hard to swallow

...Mr F drops a small metal instrument which slips down the patient’s throat. He finishes the root treatment and then immediately refers Miss D to hospital with a note explaining what has happened...

September 2011

A call regarding a sick child

...a neighbour drops by and looks in on Sara and notices a large purple mark on the child's leg. She advises Mrs P to call an ambulance immediately...

August 2011

A bad trip

...the patient's wife explains he had been bitten by mosquitos after he'd stopped taking the anti-malarial medication...

July 2011

Unreasonable behaviour

...the patient's son disagrees with the doctor about his father's condition and becomes aggressive...

June 2011

NHS or private treatment

...The dentist agrees to treat her on a private basis as is standard with all non-registered patients to the practice attending on an emergency basis...

May 2011

A matter of consent

...afterwards the patient complained that she had not agreed to undergo the type of procedure the doctor had carried out...

April 2011

Folic acid only

...with pregnancy not explicitly ruled out in the notes, it becomes a case of his word against the patient’s...

March 2011

Serious concerns

...The patient is on methadone and appears intoxicated when she attends for her appointment. Dr B is worried about her two-year-old daughter whose clothes are soiled...

February 2011

Problematic extraction

...Mrs P reports "feeling air" in the tooth socket and that when gargling she finds mouthwash trickling out her nose...

January 2011

A misfiled result

...The histology report indicates a malignant melanoma, but the letter is filed away and is not checked for several months...

December 2010

A necessary visit?

...Dr A diagnoses gastroenteritis and a possible chest infection and prescribes an antibiotic and anti-sickness medication. But just a few hours later, Mrs B dies...

November 2010

What did you call yourself?

...The dentist doesn't notice that his website designers describe him as a specialist in implantology on his new site. It's not long until a fellow dentist reports him to the GDC, claiming he is misleading the public...

October 2010

Screening not 100 per cent

...The three-year-old seemed flat-footed but within weeks he was limping. It was only when he was scanned six months later that the real problem is discovered...

September 2010

Conflicting scenarios

...on returning to the surgery the pain in his abdomen was so agonising he could "barely walk" and it had also moved from the epigastric area to "just below the right side of my stomach"...

August 2010

Too much information 

...Mrs A alleges breach of confidentiality in disclosing the full medical record instead of only the section relating to her crash injuries...

July 2010

A not so simple fever

...The baby had a cough and a high temperature and the doctor prescribed a course of paracetamol. By the time she had been seen by three other doctors, she was seriously ill...

June 2010

Dentist number one, two or three?

...The patient underwent a root canal but suffered complications over the course of two years, receiving treatment from three different dentists...

May 2010

A parent's right?

...The father wanted access to his child's records but the boy's mother did not want the information disclosed. The doctor was unsure who was right...

April 2010

A foregone outcome?

...The patient was referred to the practice's minor surgery clinic to have a mole removed. After several weeks waiting for an appointment, the lesion had changed rapidly and cancer had spread...

March 2010

Cryotherapy complication

...The FY2 had been trained in using liquid nitrogen cryotherapy… but the following day the patient developed blisters on her hands on top of the warts...

February 2010

Remembrance of dental treatment past

...Three separate dentists at the practice were involved in the patient’s treatment - none of whom were still with the practice. One had retired, another was deceased and the third had long moved abroad....

January 2010

Hazardous driving

...The assessment determined that patient’s condition posed a risk and his driving licence was revoked. A month later the GP sees the patient drive into the practice car park to attend an appointment....

December 2009

A nip too far

...the surgeon mistakenly cut off too much skin around his eye. The patient needed grafts and suffered scarring....

November 2009

Unsightly side effect

...Over time the girl and her family began to notice a blue/grey discolouration in her teeth, which was also noted by her dentist. Her father did some investigating on the internet and discovered that "staining" was a rare but recognised side-effect of minocycline...

October 2009

Pholcodine reaction 

...The patient suffered a severe reaction to the medication that required several days of hospital treatment, including time in intensive care...

September 2009

Steroids and a bad hip

...the GP received a solicitor’s letter claiming negligence in the long-term prescription of steroids which Mr P alleged led to the avascular necrosis in his hip...

August 2009

Poor records, poor defence

...the dentist did not feel the loss of the cusp was his fault. The patient did not accept this response and raised a complaint with the Ombudsman’s office...

July 2009

Dental neglect – but whose?

...Mr M remembered D well as he attended over 70 times in the period that he was a patient at the surgery. His notes constituted a long list of caries and fillings with occasional antibiotics...

June 2009

Negligence in co-proxamol prescribing

...her co-proxamol was discontinued but this was not removed from the repeat prescription list. Later when Mrs G requested a repeat prescription of 100 tablets these were retained by her...

May 2009

Adverse drug interaction

...Mr T ended up in the ITU sedated and on a ventilator. He developed septicaemia and it was thought that this may have been due to immunosuppression caused by an adverse interaction between methotrexate and trimethoprim....

April 2009

Missed fracture

...Four months went by and Mrs B appeared again at the surgery but this time saw a different GP who ordered an X-ray and it was confirmed that the patient had an undisplaced fracture of the medial malleolus of the tibia...

March 2009

Bad blood

...Mrs T found the experience so traumatic she is now paranoid about having more blood tests. She contacted her solicitor who sent a letter of claim to the surgery...

February 2009

Holiday toothache

...Mrs V returned to the surgery after the holiday. Her face was swollen and X-rays confirmed an apical abscess. She was angry and demanded that the dentist pay the balance of costs for her treatment in Thailand...

January 2009

A painful disclosure

...A senior civil servant telephoned the GP and asked if the doctor could confirm whether or not Mr L could be considered sufficiently fit enough to attend the disciplinary hearing...

December 2008

Matters of fact

...No explanation was provided as to why the facts as presented by the patient, Ms F, were so much at odds with the practice notes...

November 2008

Claim over missed diazepam

...Mr B was a drug addict and claimed that on the first day of admission to the prison the doctor failed to issue a prescription for the diazepam being used to treat his addiction...

September 2008

Ingested instrument fragment

...Despite the lack of physical injury to Mr K and a generally friendly and apparently unconcerned attitude on his part, a claim for compensation was intimated...

August 2008

Needle stick accident

...the patient's son was found sitting on the floor of the consulting room with his hand in a sharps box...

July 2008

Index of suspicion

...More calls to the surgery and deputising service resulted in additional advice to buy a cough medication and Bonjela for the oral lesions. Mr D later found his wife collapsed in the bathroom and phoned for an ambulance...

June 2008

Depot error

...Three months later Mrs B attended the surgery for her second injection [of Depo-Provera] and on this occasion the GP discovered that at the previous visit she had been given Depo-Medrone...

May 2008

A needless expense

...Two further letters were ignored at which point the solicitor instituted Court proceedings against Mr L to force disclosure...

April 2008

Priapism - failure to refer

...The GP's failure to refer Mr K led to a 96 hour delay in treatment and resulted in permanent damage to erectile tissue...

 

March 2008

Lost for words

...Mr V claimed he asked specifically about complications, risks or side-effects of the procedure. Mr A had replied that there was no risk as it was a simple operation done with a laser through the mouth...

February 2008

An unnecessary procedure

...he was at fault for first accepting the referral from the GP without having the necessary expertise and for opting for circumcision without sufficient cause... other more conservative options should have been considered...

January 2008

Informed is forewarned

...The surgeon briefed Mrs L on the procedure but did not think it necessary to discuss the very slight risk of deep infection (spondylo-discitis/osteomyelitis) attendant to the procedure...

December 2007

The good news is...

...With the subsequent delay in confirming the diagnosis, the patient's pregnancy advances to such a stage that termination can no longer be carried out locally and she must travel to London for the procedure...

November 2007

An unwelcome embellishment

...It turned out that Mr K was not an enthusiastic typist and, in situations like this, would supplement the computerised records with handwritten notes...

October 2007

Too much of a good thing

...Dr D apologises unreservedly but Mrs H makes a claim for the adverse effects suffered from the Prozac overdosage. The case is judged indefensible...

September 2007

When the truth hurts

...Upon making his request he [the patient] also asked the GP to withhold details of his alcohol abuse, stating: "doctors are entitled to withhold any information which might be harmful to the patient"...

August 2007

Don't blame the receptionist

...She recorded that there was radiation to both arms from the chest pain, and that she had referred the call directly to the locum... Dr P denied this - however the call sheet showed that the receptionist's version was correct...

July 2007

Best of bad job

...The VDP took a radiograph and noted that the root filling material had perforated the apex by 5mm and appeared to have entered the ID canal running distally by about 2mm...

June 2007

Tummy tuck complication

...Conservative treatment failed and another operation was required to remove the necrotic tissue and apply a skin graft...

May 2007

Rectal bleeding - missed referral

...A combination of recent change in bowel habit and unexplained rectal bleeding should have prompted the GP to send an urgent referral...

April 2007

Warfarin dosing error

...Relatives found Mrs W had collapsed and died, alone in the house. She had suffered a pontine intracranial haemorrhage, probably while the practice was attempting to contact her...

March 2007

Chaperone essential

Dr R, a young Foundation Year 1 doctor, saw an A&E patient presenting with abdominal pain. Dr R undertook appropriate investigative procedures which included a rectal examination. After recovery 6 months later the patient alleged that Dr R had performed the rectal examination without her consent, and without the use of a chaperone...