NHS Grampian GP misdiagnosed pneumonia patient with Covid despite coughing up blood

An NHS Grampian GP practice has been ordered to apologise after misdiagnosing a pneumonia patient with Covid-19 – despite coughing up blood.

The patient, known only as A to protect their identity, had a telephone consultation with the practice and reported haemoptysis (coughing up blood) and a fever.

A also reported that they had taken a lateral flow test for Covid-19, which had come back negative – they did not take a PCR test before contacting the GP.

Despite this, the practice considered it “likely” that A had Covid-19, and advised they self-isolate for ten days after symptoms began.

Their condition deteriorated – several weeks later, they were admitted to hospital and diagnosed with bacterial pneumonia.

Complaining on behalf of A, their partner C said that the practice did not offer a face-to-face appointment and subsequently failed to correctly diagnose the bacterial pneumonia.

The practice told the Scottish Public Services Ombudsman (SPSO) that it had been following the guidelines in place at the time and had correctly signposted A to the Covid-19 Hub for further assessment.

The watchdog took independent advice from a GP, and found that there was “no evidence in the clinical record” that A had been signposted to the Covid-19 Hub – and that haemoptysis was never listed as one of the common symptoms of infection.

It subsequently found there had been a “failure to offer A a face-to-face appointment, particularly given they had reported haemoptysis”.

The SPSO said: “We welcomed that during our investigation the practice reflected further and accepted that A’s complaint of haemoptysis merited further clinical consideration and assessment.

“Given that the practice have taken appropriate and sufficient action to learn and improve from this complaint, we did not recommended that they take any further action.

“However, we recommended that they apologise to C and A for not offering A a face-to-face appointment.”