When a routine optician appointment identifies papilloedema, Mrs T makes a claim against her GP for not giving her an earlier urgent referral.

A criminal investigation has been dismissed against a Medical Protection member, in a recent case that also underlined the value of our discretionary indemnity.

Mr B was a 31-year-old man with three children. His mother was staying with him over the weekend because he was in bed coughing and shivering.

Baby LM was taken to see his GP, Dr E, for his six-week check. During this examination Dr E noted that his left testis was in the scrotum but his right testis was palpable in the canal. He asked LM’s mother to bring him back for review in a month.

Mrs S, a 27-year-old Romanian woman who lived with her husband in the UK, became pregnant and presented to her local GP surgery to commence antenatal care. Mrs S did not speak English and usually brought a family member with her to interpret.

Mrs J, a 62-year-old housewife, did not visit her GP often. However, she consulted Dr D with a two-week history of coryzal symptoms.

Mr M, a 44-year-old architect, attended his GP, Dr C, for a skin check. Dr C diagnosed a papilloma on his right chest wall as well as a seborrhoeic keratosis skin lesion of the upper left arm.

Mr O was a 24-year-old man who had just enjoyed a holiday overseas. On the return journey he started vomiting. The nausea and vomiting continued after he arrived home and he began to lose weight because of it. When his symptoms did not abate he made an appointment with his GP.

Mrs B, 40 years old, was referred by her optician to see an ophthalmologist, Mr F, because of concerns about possible raised intraocular pressure and right-sided amblyopia. Mr F confirmed the diagnosis of right-sided amblyopia, found her to have normal intraocular pressure and documented some visual field loss in both eyes, which he considered was performance-related. He advised reassessment in six months but the patient did not attend for follow-up.

Mr J was 43 and unemployed. He developed headaches and complained that sunshine hurt his eyes and he was bothered by noise. He made an appointment with his GP, Dr A, explaining that he had tried over-the-counter painkillers but that they did not help when he had one of his pounding headaches. Dr A documented Mr J had presented with headaches with some features of migraine and prescribed some tramadol...

Mrs P was a 42-year-old housewife who lived with her husband, daughter and their first grandchild. She had suffered with chronic lower back pain for many years, which was helped by regular paracetamol.

Mrs F was a 38-year-old secretary who was pregnant for the first time. She had no significant past medical history of note. Her pregnancy had been uneventful, but a glucose tolerance test at 28 weeks confirmed that she had gestational diabetes and was treated appropriately. She went into labour spontaneously at 37 weeks. The first stage of the labour progressed well; however, the second stage of labour was prolonged.

Twenty-year-old Miss D was referred to orthopaedic consultant Mr A for assessment of an old clavicle fracture. Two years previously, Miss D had sustained a clavicle fracture after falling off her bike. This injury was treated in a different hospital in a conservative way, using a collar and cuff sling. In the early follow-up period, she moved to her current address and she was lost to further review.

Mrs F was a 28-year-old teacher with two children. She had been fit and healthy for most of her life, but had seen her GP, Dr T, four times in two years with urinary symptoms. At each visit she complained of discomfort passing urine and of needing to pass urine with increased frequency. She had also noted that the urine had a “strong smell”. She had never felt particularly unwell with these symptoms and had not been feverish or suffered with loin problems...

Mr Q, a 40-year-old man, booked an emergency appointment to see Dr A. He presented with a severe headache. He told Dr A that it had come on suddenly and was very worried as to the cause, as he had not experienced a headache like it before. He had a history of tension headaches and had been seen and investigated by a neurologist during the past year to rule out other causes of his recurrent headaches. Mr Q also had a long history of anxiety and panic attacks.

The right of Sandy Anthony to be identified as the author of the text of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988.

Ms C, a 30-year-old hotel receptionist, went privately to see Mr T, a plastic surgeon to discuss surgery to change the appearance of her nose. She had been unhappy with its appearance for a number of years, and finally decided to have a rhinoplasty. Mr T explained the risks and benefits of the operation as well as the limitations of surgery.

Mrs F, a florist, had been diagnosed with hypertension while still in her twenties. She was a frequent attender at her GP practice, often seeing the practice principal, Dr W.