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Case ref:201406016
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Date:November 2015
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Body:A Medical Practice in the Highland NHS Board area
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
Mrs C's father (Mr A) visited the practice on several occasions with stomach problems. Although an endoscopy (an investigation of the stomach using a camera) was considered early on, Mr A was instead treated for stress and anxiety for about six months, before an endoscopy was arranged. The endoscopy led to a diagnosis of stomach cancer.
Mrs C raised concerns that Mr A was not referred for an endoscopy sooner, and referred to an online article that recommended urgent referral for patients over 55 with unexplained and persistent dyspepsia (indigestion).
After taking independent medical advice from a GP adviser, we did not uphold Mrs C's complaints. Our adviser considered the GP's actions were consistent with the national guidance on dyspepsia, and reasonable in light of the information known at the time. Our adviser said that Mr A's dyspepsia was not unexplained, as he had been diagnosed with stress (and there were several factors that supported this diagnosis, including that Mr A's symptoms seemed to respond to medication for this). Our adviser also noted that the GP had appropriately checked for any 'alarm features' and regularly checked Mr A's blood tests. When Mr A's blood test showed an abnormality, he was appropriately referred for an endoscopy.