Page Section: Left Content Column
Page Section: Centre Content Column
Failure of GP to follow up on results of referral for ultrasound, which patient was to arrange (01HDC08770)
Download Failure of GP to follow up on results of referral for ultrasound, which patient was to arrange (01HDC08770) (PDF 12Kb)
(01HDC08770, 9 April 2003)
General practitioner ~ Standard
of care ~ Follow-up of test results ~ Rights 4(1), 4(4)
A woman complained that a GP did not provide services of an
appropriate standard to her 25-year-old son or supply him with
sufficient information in that the GP:
1) told her son that his testicular lump was probably a cyst
and nothing to worry about, despite her son asking whether it was
2) did not explain clearly the importance, urgency, or need
for the recommended ultrasound; and
3) did not have a "bring-up" system to monitor the arrival of
test results and to notify the patient of the results or, if the
patient had not had the test, to follow up with the patient to
reinforce the need to have the test done.
The Commissioner reasoned as follows:
1) Although the GP did suggest that the lump was more likely
to be benign than malignant, this was statistically correct and
reasonable advice, especially as the patient did not display any
particular risk factors.
2) The GP gave appropriate advice in stating that cancer
could not be excluded without a scan, and referring the patient to
have a scan performed.
3) The GP should have followed up his referral to see
whether the patient actually attended for an ultrasound, either
through repeat clinical examination or use of a system to check
whether referrals have actually been performed or attended within a
designated time frame. Any tests or investigations ordered where
the doctor has reason to suspect a diagnosis of malignancy require
prompt follow-up by the requesting doctor. In assessing the
doctor's follow-up, it is no excuse that the reason for any delays
in the results (such as the patient's decision not to have the test
performed) may be outside the practitioner's control. At the least,
the doctor needs to make reasonable enquiries as to why the test
results have not become available.
It was held that the GP did not breach Right 4(1) in respect of
his assessment of the patient's condition or the advice he gave to
the patient, but breached Right 4(4) in not having an appropriate
bring-up system in place and in failing to follow up the referral
for an ultrasound in a timely manner.
The Commissioner commented that it is preferable for GPs to make a
direct referral to the agency the patient has chosen for the
investigation rather than simply give the patient the request form.
Such direct referral ensures transfer of care and facilitates the
audit of test results.
Page Section: Right Content Column
Top of Page