To complain about GP?

[Hinchunup]

My son has been ro GP on three occasions with testicle pain. Std checks, urine samples followed by 2 courses of antibiotics despite no infection found. This went on for 3 months. Referred for scan with no abnormalities found. This weekend he had pain and vomiting and went a and e as I had no faith in GP. He had emergency surgery and had his testicle removed on Friday. We're horrified at misdiagnosis and want to complain but have been with go for many years . Does anyone have advice?

Why don't you arrange an appointment with the Practice Manager in the first instance?

So what was the diagnosis? Sounds like gp treated and referred appropriately unless I'm missing something?

I’m not sure what you expect the GP to do and why it’s his fault.

Your son had scans, numerous tests and antibiotics as a precaution, why are you blaming the GP.

If he’s had a twisted testicle, it’s really common and as it untwists and twists itself it’s just unfortunate that your sons was untwisted when he had his scan.

What is the mis-diagnosis?

How old is your son? It sounds as if the symptoms changed from the initial symptoms to the ones last Friday where you say he was vomiting.

Definitely worth seeing the GP to discuss what happened.

Thank you. I think a referral to urologist following the second presentation may have helped? Following his surgery the urologist explained that the scan would not have diagnosed the torsion in the spermatic chord. I want to find out how this could have been avoided and I will absolutely be requesting meeting with lead GP. Just posting for advice before hand

It couldn’t have been avoided unfortunately, as previously said it’s quite common and difficult to diagnose if it’s not twisted.

Unfortunately most suffers have to be be at the vomit and extreme pain for it then to be formally diagnosed, as until that point it’s extremely hard to give a 100% accurate diagnosis.

I’d put the appointment on (if your sons under 18) however you’d get the same answer as above.

Ok look I am not belittling anything that your son has gone through but the GP did all the tests and exams he had available to him and could not pinpoint an issue and is not a specialist. I don’t think you can say this was a misdiagnosis for something they did not find, but ask why a referral was not done earlier. That is a fair point and you can ask. I would not go in guns blazing that he was misdiagnosed though, you need to gather facts. The urologist told you that it wasn’t seen on the scan, which does not indicate the sonographer or GP had a concern about it

Doesn't sound as though there are grounds for a complaint. How old is your son OP?

But your GP followed protocol and treat initial symptoms then referred you on for a scan where nothing abnormal was found. So no I think YABU, illness comes on unexpectedly, I would not complain because you'd DS was looked at and treated.

The GP did nothing wrong. They worked with the available information at the time, and there was no way of diagnosing it. If they referred everyone for everything you'd never get an appointment. The outcome would not have been any different for your son.

Hope your DS is making a recovery OP. It sounds deeply traumatic experience for the family. 💐

You can make a complaint and see what the response in. I can understand that you would be upset at the outcome for your son. But not all things can be foreseen and it’s not necessarily anyone’s fault. The ultrasound was the correct next step.

I can see this is a very difficult scenario, your son presented several times and eventually has had surgery and lost a testicle, which is significant.

However, your GP did not know this was happening and ignored it, the scan didn't show it and it wasn't followed up, your son was given treatment (albeit unsuccessful). Being unable to diagnose a condition that comes and goes isn't grounds for a complaint.

But speaking to the practice manager might assist you in understanding whether more could have been done. Should the GP have told your son to come back to check, should a referral have been made, what steps would have lead to an earlier diagnosis.... and would any of these things ended in a different outcome (I am not sure what intervention can be done).

Sigh; I love the NHS so much and have definitely got my money’s worth out of them - but I’ve had two problems over the year where things weren’t referred suitably which has consequently lead to me having three major surgeries.

I have never complained; I have initially been really angry when I realised what have happened, but decided to see it through and take a view on my overall care. I should say that in the second instance of non-referral, it has lead to me losing a substantial part of one major internal organ and the entirety of another, so I completely understand your frustration with the system.

I have always found with the NHS you have to fight to get symptoms taken seriously, especially if you’re younger - but once you get to the right person (normally a consultant, or even just a really diligent nurse practitioner or GP) they sort it out and are absolutely brilliant.

In the first case, my consultant was so pissed off with what had happened that he made a formal complaint for me, without me asking, and copied me in, accusing them of negligence.

In the second case, I have seen that the GP surgery have already changed the way they do things as my mum presented with the exact same symptoms and has immediately been referred to every test under the sun, and has been taken very seriously indeed.

So I think I they are aware of these errors and are self-correcting. But I know that doesn’t make your frustration or your son’s pain any less easy to cope with.

The lesson I have taken is to go back for second opinions if things aren’t working out right. This is especially crucial for when you are young. It’s always been one inaccurate decision by one practitioner, out of a sea of many excellent decisions by deeply caring ones - so I think always getting that second opinion is my approach now. I know you shouldn’t have to but I think with the lack of funding in the NHS, practitioners are overstretched and can miss things.. so yeah, second opinion is my safeguard against that.

The GP is front line, they can't know literally everything and I suOect lots of people come in with similar complaints that are sorted out and aren't so 'bad' ...and the GP did send him for investigative tests - your sons symptoms changed and sought more help, if you'd have taken him to the GP then and they'd done nothing then fair enough, but all GPs say if symptoms change or get worse seek more help - which you did and problem solved

Thank you for the advice. We are indeed traumatised, he is only 21 and devastated. It was so sudden and unexpected, but he is thankfully on the mend. I will ask the practice to raise awareness in cases where patient re presents with similar symptoms in order that they can consider referral to specialist more readily. I believe that had we knowledge of the condition he would have sought help as soon as the pain started. He had felt the pain in the days prior to the acute onset and took pain relief as he didn't believe gp could help. Had we known what may have been happening we would've sought help earlier with the possibility of a better outcome.

You will need to ensure your DS signs a letter authorising the practice to discuss his case as he is an adult. If your in England there will be a complaint process in the GP practice and you can also complain via the CCG.

Torsion is hard to diagnose and acute torsion usually presents as severe pain and vomiting. Chronic pain is more unusual but should be referred to a urologist immediately. Scanning is useless in torsion diagnosis and surgery is needed for definitive diagnosis.
It is just possible his testes would have been saved with earlier urology assessment but lots of hospitals miss it too. He’s quite old for a torsion which wouldn’t have helped with diagnosis.

I don’t think complaining will help and that would be up to your son, not you, they won’t enter discussion with you. You could write saying you were disappointed they had missed it and not followed guidance.

It’s an unpleasant thing to go through but unlikely to have long term implications for him. So I suspect your reaction will diminish quite quickly and it might be better to wait and take a more measured approach.

I am a urologist and had a similar patient with intermittent pain. I didn't think of torsion and he lost it a few weeks later. We were sued and paid out.

I think there are grounds for complaint. If the gp couldn't treat, or figure out what was wrong with your son then he should have reffered him to someone that could instead of handing out unnecessary antibiotics.
You will find on MN GP's can do no wrong OP, a bit like teachers.

The GP is front line, they can't know literally everything

They should know basic symptoms of something that is pretty common, but you are correct, they don't know everything, infact I have witnessed GP's Google my symptoms infront of me!

'I am a urologist and had a similar patient with intermittent pain. I didn't think of torsion and he lost it a few weeks later'
You are obviously an expert so wouldn't dare to judge, but can I ask why you wouldn't have thought of torsion as a possible cause? The moment I started reading the OP I wondered if it was going to finish with her saying it was torsion. When my boy started to complain of pain there, my first thought was to watch for this possibility. I'd had a friend who son was diagnosed with it but thankfully had surgery on time so I was aware of it.

I didn't think it was that uncommon, I know three men to whom it happened. Is it so? I'm just surprised that a GP, let alone a Urologist wouldn't have considered torsion as a likely possibility for the pain. It would be helpful to understand more what lead to the consideration of such diagnosis.

Hi op sorry this happened to your son sounds awful. Im not medical but I work in admin for nhs if your son wants to complain ( you can't do this on his behalf unless he authorised you to do this) The surgery can't speak to you unless this happens. You would usually ask for a copy of complaints procedure then put the complaint in writing. You will then get a response to the complaint. You could also see if there is protocol for treating this type of condition within your trust and see if the doctor followed it. It does sound though as if the doctor has tried to treat the condition and it wasn't found on the scan. Your son can also request a copy of his medical notes aswell.

Another person here who doubts that a urologist wouldn’t consider a torsion. My son had a testicle op age 14 due to what turned out to be a cyst but was a suspected torsion.
If the GP wasn’t following protocol I would definitely get your son to complain to the GP manager- but don’t do it for him. Has he had a prosthetic testicle?

Totally agree with Swingofthings. Hard to understand how torsion is not even thought of for testicular pain. I know we all make mistakes but.