Claim settled against two GPs following failure to consider a longstanding diabetes diagnosis during telephone consultations, leading to diabetic ketoacidosis

Case Studies

Claim settled against two GPs following failure to consider a longstanding diabetes diagnosis during telephone consultations, leading to diabetic ketoacidosis

We have recently achieved a settlement for our client, whose husband sadly passed away as a result of severe diabetic ketoacidosis.

Our client’s late husband was diagnosed as a type I diabetic in early childhood and had managed his diabetes well ever since. On 7 February 2016, he began suffering with back pain and, by the following day, the pain was so severe that he could not get out of bed, eat, or take his insulin.

Our client telephoned their GP surgery on 8 February, as her husband was in too much pain to make the call himself. She relayed the symptoms her husband was experiencing, stressing how much pain he was in, and informed the GP of her husband’s diabetes and that he hadn’t taken any of his insulin. Instead of addressing the lack of insulin, the GP prescribed pain medication, which our client collected immediately following the telephone consultation.

Unfortunately, the medication had little effect and our client’s husband spent the night in severe pain. The following day, her husband telephoned the GP surgery again, as the pain had not subsided and he was now vomiting a brownish liquid. He spoke to a different GP and had to interrupt the conversation at one point to be sick. The GP did not ask any questions regarding his vomiting and only advised that he continue with the pain relief. The GP suggested that, if his situation had not improved in a couple of days, he should call the surgery again and they would consider stronger pain relief.

In light of the second GP’s advice, our client continued to nurse her husband in bed. By that evening, he was still in severe pain, vomiting approximately every 20 minutes, and unable to keep any fluids down. By the early hours of the following morning, he was confused and appeared to be hallucinating.

On the morning of 10 February, our client was unable to rouse her husband. She immediately phoned for an ambulance and performed CPR as instructed until the ambulance arrived. Sadly, the paramedics confirmed on arrival that her husband had passed away. Toxicology reports concluded that his death resulted from diabetic ketoacidosis associated with acute gastritis and gastrointestinal haemorrhage.

Investigations were carried out as part of a clinical negligence claim, led by our specialist team, and it was alleged that there were failures by both general practitioners to treat our client’s husband with the competency that should reasonably be expected of a GP. It was alleged that a reasonably competent GP, on being told that a diabetic patient was in severe pain, not eating, and not taking their insulin, would have been concerned.

Expert evidence outlined that, in this instance, our client’s husband should have been advised to test his blood glucose level, which would have been notably elevated, and thereafter advised to restart his insulin. Had this advice been given by either GP, our client’s husband would have made a full recovery.

As part of the investigation our client’s husband’s medical records were obtained. The notes of the issues discussed with both GPs did not make any reference to his history of diabetes or his lack of insulin. However, at a subsequent meeting with our client, it was acknowledged by one of the GPs that there was a failure to consider our client’s husband’s diabetes during these consultations.

Although the defendants maintained their denial of liability throughout, we are pleased that we were able to negotiate a settlement for our client, giving her certainty and closure without the need to proceed to trial.

No sum of money will ever be able to compensate our client and her family for the loss of her husband but it is hoped that, as a result of the investigation, the general practice staff will learn from this case to ensure that patients’ pre-existing medical conditions are fully considered during consultations where a patient is not physically assessed by a GP, especially given the increasing prevalence of telephone consultations in the wake of the pandemic.

This case also highlights that, unfortunately, despite acknowledgement within the practice that there may have been failings in care, this does not always mean that a defendant will make the same admissions as part of any clinical negligence case. It is for that reason that appropriate advice is sought from experienced clinical negligence lawyers to ensure that cases are handled with care and expertise, and all potential areas of concern are explored.

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Penningtons Manches Cooper LLP