Case study
A scarring problem Dr S was a city centre GP with a special interest in minor cosmetic surgery. Mr A attended Dr S’s clinic for the removal of a small sebaceous cyst at the corner of his left eye. Various options for its removal were discussed, including a referral to a plastic surgeon.
Mr A was happy to go ahead with the procedure under Dr S the next day. Dr S warned that the removal would result in a facial scar, but Mr A responded that he would rather a scar on his face than the cyst, as it was causing him anxiety. This discussion, which outlined Mr A’s psychological state, was not recorded in Mr A’s medical notes. Neither was any record made of the verbal consent taken.
Dr S removed the cyst using a disposable minor surgical kit and a vertical incision. A sample of the cyst was sent to histology for further examination before Dr S sutured the area and applied a dressing. He advised Mr A to return in one week, or to return sooner if he had any concerns. Mr A was prescribed antibiotics and directed to use these for the next seven days. He did not return for follow-up.
Following the procedure, Mr A was left with a vertical scar together with a small white cyst-like lesion within the scar. Mr A was unhappy with the outcome and was increasingly worried that the scar might have affected his vision. He made a claim against Dr S, alleging that the cyst had been negligently removed.
Expert GP opinion found that Dr S’s medical records were scant and as a result they were critical of the lack of detail outlining the consent taken, the discussion around the possibility of scarring, and Mr A’s underlying psychological issues. Expert opinion was also critical of the fact that Dr S did not chase Mr A when he failed to return for follow-up after seven days.
There was no safety-netting in place. However, ophthalmological opinion found that the removal of the cyst did not affect Mr A’s sight in any way. The case was settled for a small sum.