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Case ref:201508423
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Date:December 2016
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Body:A Medical Practice in the Lanarkshire NHS Board area
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Sector:Health
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Outcome:Some upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Mrs C, who works for an advocacy and support agency, complained on behalf of Ms A about a GP home visit when Ms A reported severe dizziness and staggering. Ms A was diagnosed with labyrinthitis (an inflammation of the inner ear), but it was later discovered that she had suffered two minor strokes. Mrs C said that the GP should have considered the possibility of a stroke and admitted Ms A to hospital by ambulance. Mrs C also said that it was unreasonable for the GPs at the practice to prescribe statins (medication used to lower cholesterol in the blood) to Ms A.
We took independent advice and found that the care and treatment provided to Ms A at the home visit was reasonable. It was appropriate to diagnose labyrinthitis and there was no clinical evidence at this point to suggest that Ms A had had a stroke. However, there was an unreasonable delay in making a referral to a stroke unit, and there was a failure to carry out a particular examination which would have been reasonable in light of Ms A's symptoms, which included hypertension. In relation to the prescription of statins, we found that this was reasonable in the circumstances.
Recommendations
We recommended that the practice:
- ensure their systems for sending hospital referrals are such that referrals are sent within a reasonable time, and there is no recurrence of unreasonable delays;
- ensure the relevant GP familiarises themselves with guidelines for the management of hypertension; and
- apologise for the failings identified in this investigation.