COMPLAINT MISSED GALLSTONES


BACKGROUND A 16-year-old patient – Mr P – attends his GP surgery complaining of abdominal pain. He is seen by Dr H who examines the patient, diagnoses constipation and prescribes medication to relieve the symptoms. The next week he again presents with similar symptoms and Dr H prescribes a different laxative. Over the following six weeks he attends


the practice three more times and is examined by two different GPs who also diagnose constipation. On his third visit, Dr J refers him for specialist treatment. In the meantime, the patient attends on two more occasions and is given further medication to relieve his constipation. Mr P attends hospital and is seen by Dr N


who also suspects constipation. He administers sodium picosulfate and the patient is discharged the next day. His pain worsens over the following two weeks and


he is readmitted to hospital. An ultrasound shows multiple gallstones and he undergoes surgery two weeks later to remove his gallbladder. He is eventually discharged with pain relief, having lost a significant amount of weight. The practice receives a letter of


complaint from the patient’s mother who demands to know why her son’s gallstones were not diagnosed sooner.


ANALYSIS/OUTCOME An MDDUS adviser helps in drafting a response to the complaint, having ensured consent from the patient to allow his mother access to all correspondence. In the letter, the practice expresses regret


that there was a delay in the diagnosis. It notes that the Mr P was referred to a specialist within weeks of first presenting with abdominal pain and the examination and treatment of the patient was carried


out in an appropriate and timely manner. The letter explains that gallstones are rare in such a young patient and his symptoms strongly indicated constipation, a diagnosis also suspected by the hospital. The practice offers a meeting to discuss the matter and the complaint ultimately progresses no further.


KEY POINTS ●Delays in diagnosing less common conditions do not always amount to negligence where doctors can evidence careful and thorough examination and treatment. ●A comprehensive and carefully written response, including an expression of regret, can lead to early resolution of complaints.


COMPLAINT


ANONYMOUS COMPLAINT


BACKGROUND A dental practice receives an anonymous letter of complaint accusing one of their nurses of being rude and dismissive during a recent visit. There is a mobile number but no name or address is provided. The practice manager contacts MDDUS to ask whether they have a duty to respond to the complaint or, considering it is anonymous, would be within their rights to ignore it.


ANALYSIS/OUTCOME An MDDUS adviser discusses the matter with the manager and advises her in the first instance to call the mobile number provided in the letter to try to identify the complaint’s author. If that can be established, the next step would be to discuss the issue and confirm whether the person wishes to take the matter further or whether they can be suitably reassured


by telephone. If they would like to escalate the


complaint, the manager would then have to follow the practice complaints procedure – conducting an investigation into the allegations and issuing a formal response to the complainant within required timescales. The complainant should be given contact details for the Ombudsman if unsatisfied with the practice response.


KEY POINTS ●Do not be tempted to dismiss anonymous complaints – investigate them as fully as possible. ●Effective communication can help resolve most complaints at an early stage.


MDDUS INSIGHT / 17


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