GP Practice's failure to repeat blood tests resulted in delayed diagnosis of a thyroid condition

What happened

Mrs R went to the GP Practice for advice as she and her husband were trying for a baby but had been unable to conceive. A GP arranged for blood tests to be carried out. These showed that Mrs R's thyroid–stimulating hormone level was high and should be tested again in three months. The Practice did not arrange a repeat blood test. Mrs R attended the GP Practice on several occasions after this about related issues but a repeat blood test was not carried out.

Mrs R later went on to conceive but suffered two miscarriages. She was diagnosed with hypothyroidism, an underactive thyroid gland, two years later.

What we found

In line with good clinical practice, it was the GPs' responsibility to ensure that the appropriate investigations were carried out when the blood test showed that Mrs R's thyroid–stimulating hormone level was raised. There was no evidence that Practice staff made arrangements for repeat blood tests at the initial consultation, and at subsequent appointments the GPs did not take action to address this.

We concluded that the lack of action by the GPs had delayed Mrs R's diagnosis of hypothyroidism by two years. However, whilst hypothyroidism can cause low fertility and increases the risk of miscarriage, there are many other factors that can contribute. Therefore, we could not say that the failure to diagnose and treat hypothyroidism caused Mrs R's low fertility or resulted in her miscarrying.

Putting it right

We decided that it was likely that Mrs R was put at increased risk of low fertility and miscarriage because of the failings by the GP Practice. The GP Practice had closed before Mr and Mrs R complained so NHS England took responsibility for dealing with the complaint. NHS England paid Mr and Mrs R £750.