Missed opportunity to diagnose infantile spasms

What happened

Mr and Mrs A said that it was difficult to describe their son's symptoms (rolling of the eyes and seizing up) and they brought a video to show the doctor. A GP registrar, a doctor training to be a GP, suggested that the symptoms were due to infantile colic but advised them to return if there was any recurrence. The symptoms continued for a couple of months.

In 2014 Mr and Mrs A complained to the Practice. They said that B had developmental issues and that paediatricians said that B had in fact suffered infantile spasms. Mr and Mrs A complained that the GP registrar should have done more and that there was a missed opportunity to get help sooner for B.

They also complained that the Practice did not supervise GP registrars appropriately.

The Practice provided a response and also arranged a local meeting.

What we found

We partly upheld this complaint. The Practice had provided appropriate supervision for the GP registrar. However, there was a failing in the GP registrar's actions.

The failing was not that the GP registrar missed the diagnosis of infantile spasms (which is an uncommon condition) but that she failed to recognise that this was not infantile colic. The GP registrar should have sought help from a more experienced GP, who could have made the diagnosis and given an appropriate referral to a specialist.

If diagnosed appropriately, B would have undergone an urgent examination and received treatment. There was a good chance that medication would have completely suppressed the infantile spasms at the time.

B's parents were distressed by his illness and they continue to be distressed by his developmental delay. However, we could not say that if the failing had not happened, B's developmental problems, and therefore their distress, would have been avoided.

Although it was unlikely that the outcome for B would have been any different if the GP registrar had acted differently, we concluded that there was a missed opportunity to get immediate treatment for B to relieve his symptoms. In addition, both B and his Family will have to live with not knowing whether more could have been done to prevent or minimise his difficulties.

Putting it right

The Practice provided a further apology for the failing and paid Mr and Mrs A £1,000 compensation to recognise the impact of this on them. It also explained how it would make sure that patients know that they may be seen by a GP registrar.