Summary
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Case No. E.515/97-98
Treatment by deputising doctors and monitoring of a GP deputising service
Matters considered:
Inadequate assessment and treatment by deputising doctors—arrangements to monitor deputising service—handling of complaint.
Complaint against
A deputising service; South Essex Health Authority; a GP in the Authority's area.
Summary of case
In June 1996, Mrs X called for a doctor, out of hours, to visit her husband, who was in pain. A deputising doctor arrived, made a brief examination, gave a painkilling injection, and prescribed antibiotic tablets for a possible kidney infection. Mr X became more ill after taking a tablet. Mrs X again phoned the deputising service; and a second doctor advised that Mr X should continue with the tablets. Mr X became even more ill after taking another tablet; and Mrs X called out a third doctor, who identified the tablets as penicillin-based. Mr and Mrs X said that Mrs X had told the first and second doctors that Mr X was allergic to penicillin. Mr X later recovered. Mrs X complained about the actions of the first two deputising doctors and about the standards of doctors working for the deputising service.
Findings
The deputising service's tape-recording of Mrs X's conversation with the second doctor showed that she had told him that her husband was not allergic to penicillin. Mrs X then withdrew that part of the complaint. The Ombudsman obtained a report on the clinical aspects of the case from two independent professional assessors. He criticised the first doctor, because his examination of Mr X had been perfunctory, his assessment of Mr X's condition had been inadequate, and his treatment had been inappropriate. Although regulations say that GPs are responsible for the actions of doctors who deputise for them, the Ombudsman recognised that in reality the GP had no control over the deputising doctor's actions that day. The Ombudsman took the view that the deputising service could not wash its hands of responsibility. He upheld the complaint about inadequate treatment against the GP and the deputising service. He noted that there had been 15 previous complaints to the deputising service about the first doctor. He upheld a complaint that the Authority had failed to monitor the adequacy of the service (they were responsibile for that between April 1996 and March 1997). The Ombudsman also found that the Authority had taken inadequate action in response to Mrs X's complaint.
Remedy
The deputising service, the Authority, and the GP apologised to Mrs X.
