A FIFE woman lost her foot after she was misdiagnosed with chilblains.

The Scottish Public Services Ombudsman (SPSO) was called in after she complained about the treatment she experienced from her medical practice, which is in the NHS Fife board's area.

She had reported during consultations at her surgery that her right big toe was cold, blue and painful. The pain continued and she received additional painkillers. Blood tests revealed a low iron count and iron tablets were prescribed.

The pain continued and Mrs C also reported pain in her leg at the groin which was diagnosed as a groin strain. She continued to report problems and a referral was made to the vascular (circulatory) service where it was found she had blood clots in her leg and groin which resulted in her requiring an amputation of a foot.

The SPSO said they took independent advice from a GP while investigating the complaint.

"We found that initially it was felt Mrs C had chilblains (a painful, itch/swelling on a hand or foot, caused by poor circulation in the skin when exposed to cold) which was not unreasonable given the presenting symptoms," stated the Ombudsman report.

"However, when the symptoms persisted, the practice should have considered an alternative diagnosis of critical ischaemia (limb threat due to peripheral artery disease) rather than continue with chilblains.

"We also found that the diagnosis of tendonitis (groin strain) was unreasonable as Mrs C had not sustained an injury and that safety netting advice should have been given to Mrs C when she was prescribed painkillers."

The SPSO ordered the practice to apologise to Mrs C for the delay in staff considering an alternative diagnosis that Mrs C's foot problems were attributable to chilblains and for the failure to carry out an appropriate examination and assessment of Mrs C's reported groin problems.

To put things right for the future, the Ombudsman said staff should be aware to consider alternative diagnoses where the symptoms, which were felt initially to be attributable to a named diagnosis, were persisting.

It also said staff should carry out appropriate assessments in view of a patient's presenting symptoms.

A spokesperson for NHS Fife said it was not appropriate for them to comment as the report related to a medical practice in the board area, rather than the health board itself.

He added: "Medical practices operate independently and it is the practice directly who have been instructed to apologise to the complainant, rather than NHS Fife."