The clinical negligence team at Penningtons Manches LLP has recently settled a claim against a GP for the failure to offer an appointment to a patient when he called the surgery with symptoms of pulmonary oedema and myocardial infarction (heart attack).
The claimant had a significant pre-existing history of hypertension and Chronic Obstructive Pulmonary Disease (COPD), and had previously undergone coronary bypass operations. He frequently suffered episodes of mild shortness of breath and was under the care of a cardiologist at the time of the events in question. He had been diagnosed with a reduced ejection fraction, ie his heart was failing to pump as efficiently as it should have done.
On this occasion, the claimant called his GP surgery complaining of an increased shortness of breath, and discussed his concerns with his usual doctor. The GP, based solely on the telephone conversation, attributed his symptoms to an exacerbation of his existing COPD and did not offer him an appointment.
The claimant’s breathing difficulties worsened over the next couple of days, so he called 111. An ambulance was dispatched and took him to hospital where an ECG confirmed that he had in fact suffered a myocardial infarction. The breathing difficulties were due to pulmonary oedema, a fluid build up in his lungs as a result of further damage to his heart.
Penningtons Manches was instructed by the claimant, and after reviewing his notes, the clinical negligence team sought expert evidence from a GP and cardiologist. The experts found that as the patient had an extensive history of cardiac problems, and considering the potential seriousness of any shortness of breath, he should have been seen that day by his GP.
Unfortunately, as the myocardial infarction had already occurred by the time the claimant called his GP, the damage to the heart was already done. However, on the basis of expert evidence, a letter of claim was submitted to the GP’s defence union, and an out of court settlement was agreed to reflect the increased pain and suffering as a result of the GP’s failure to see the claimant on the day he called and treat the pulmonary oedema.
Philippa Luscombe, a partner in Penningtons Manches' clinical negligence team, commented: “This was an interesting case which highlights the responsibility of GPs to offer appointments to patients with a change in their condition. Shortness of breath can very often be an indicator of serious illness, and even if there is an apparent explanation with an underlying condition, patients are often very attuned to changes in their condition, so their concerns should be listened to and acted upon.”