Decision Report 201502335

Summary

Ms C attended her GP with swelling and hardening tissues between her vagina and rectum. The GP prescribed antibiotics to be taken for seven days. She was told to return in one week, or sooner if her symptoms became worse. Three days later, she returned to the practice and saw a different GP as the pain was worse. The medical notes also state that she was experiencing diarrhoea and vomiting. She was examined and the medical records indicate that her vaginal symptoms were no worse, and that the GP considered the diarrhoea and vomiting to be side effects of the antibiotics. On Ms C's request the GP prescribed anti-sickness medication. The GP told her to take the antibiotics for only five days, recorded that there was no sign of infection and gave her a one-week sick note. Six days later, Ms C attended the first GP again, who diagnosed a perianal (situated in or affecting the area around the anus) abscess. Ms C was admitted to hospital. Ms C complained that, at her second appointment, the GP had failed to provide adequate medical advice, care and treatment.

We obtained independent advice from one of our GP advisers. We concluded that, while the care and treatment provided to Ms C was reasonable, it was unreasonable that Ms C was not given any specific instructions by the GP at the second appointment about what to do if her vaginal symptoms did not improve or got worse. As this particular failure was significant, we upheld Ms C's complaint. During our investigation, the practice apologised to Ms C and the GP reflected on her practice. The GP explained that, in future, she would try to give more specific instructions for patients so they are sure they can come back if they need to. Therefore, we did not consider that we needed to make any specific recommendations.