Decision Report 201302257

Summary

Mrs C complained to us about orthopaedic treatment (treatment of conditions involving the musculoskeletal system) that she had on her foot. A surgeon at the Southern General Hospital operated on it twice. The operations were nearly two years apart, and both left her with ongoing symptoms. When her symptoms persisted, she was referred to another surgeon, and had a different operation. This was successful, and Mrs C's symptoms significantly improved. At this point she became concerned about whether the previous treatments had been appropriate, and complained to the board.

The board did not respond to Mrs C's complaint, as they considered it to be outwith their timescales. The surgeon provided a statement, however, in which he reviewed his assessments and treatments for Mrs C. He also referred to clinic appointments that were not appropriately recorded.

We took independent advice on this complaint from one of our medical advisers, a consultant orthopaedic surgeon. He reviewed Mrs C's orthopaedic treatments, and while he was critical that the first surgeon had not maintained appropriate clinical notes, he considered that the operations Mrs C had were appropriate. He said that the operation carried out by the second surgeon was a more complex and risky procedure, and that it was appropriate for alternative approaches to be tried first. He also noted that the last operation was normally only carried out by specialist foot surgeons. Having taken this advice, we decided that the treatment had been appropriate, and that it was reasonable for the first surgeon to try less complex and risky procedures before considering more complex treatment.

Recommendations

We recommended that the board:

• ensure that the doctor involved maintains appropriate clinical records in line with the standards set by the General Medical Council, bearing in mind the comments made by this office, and discusses any learning points at his next appraisal.