Patient’s foot amputated after GP’S wrong diagnosis

● Treatment given was for chilblains ● Critical failure to assess groin pain

A GP surgery has been ordered to apologise to a patient who had her foot amputated after she was wrongly diagnosed with chilblains.

It later emerged that the woman, identified only as Mrs C, had blood clots in her leg and groin which resulted in her needing to have her foot amputated.

Chilblains are uncomfortable and itchy, but rarely cause any permanent damage. The patient, known only as Mrs C, from Fife, complained about the treatment she received at her local medical practice to the Scottish Ombudsman. She went to her GP about prob - lems with her foot.

During consultations she complained her right big toe was cold, blue and painful. The pain continued and she received additional painkillers.

Blood tests revealed she had a low iron count and iron tablets were prescribed but the pain continued.

Mrs C also reported she had a pain in her leg, at her groin, which was diagnosed as a groin strain.

Mrs C continued to tell medics about her health issues and a referral was made to the vascular service.

There, it was found she had blood clots in her leg and groin which resulted in her needing to have her foot amputated.

The ombudsman took independent medical advice from a GP.

The investigation found initially that medics felt Mrs C had chilblains – a painful itch or swelling which is caused by poor circulation when exposed to cold.

The ombudsman said this was not unreasonable, given the symptoms she presented, but added that when the symptoms persisted the practice should have considered an alternative diagnosis of critical ischaemia, a peripheral artery disease which threatens limbs, rather than continue to think it was chilblains.

The probe also found the diagnosis of tendonitis – groin strain – was unreasonable as Mrs C had not sustained an injury, and“safety netting” advice should have been given when she was prescribed painkillers.

The ombudsman told the practice to apologise to the patient for the delay in staff considering an alternative diagnosis and for failing to carry out an appropriate examination and assessment of her groin problems.