NHS Fife has apologised to a patient after they were not given an x-ray which could have missed a foot injury.

The person, known as patient C, presented at A&E with a painful left foot and was diagnosed with a foot sprain.

However, a few months later, they were diagnosed with a rare degenerative condition and a possible healing fracture in their foot was also noted.

They complained to the Scottish Public Services Ombudsman and had their complaint upheld.

The Ombudsman's decision report said that the patient had complained that the A&E doctor had not physically examined the foot, had not carried out an x-ray and had not taken a medical history.

They stated: "As such, a possible fracture may have been missed and a diagnosis of the degenerative condition was not considered. As a result, C felt that the correct treatment was not offered.

"We took independent advice from an emergency medicine adviser. We found that the condition in question is rare and unlikely to be diagnosed in an A&E setting.

"It was also not clear whether the possible healing fracture had been present at the time. However, it would have been appropriate to carry out a physical examination, to take a medical history and to carry out an x-ray. Overall, we upheld the complaint."

NHS Fife was told to apologise to patient C for not carrying out a physical examination and not taking a medical history, such that an x-ray was not considered.

In order to avoid such occurrences in the future, they advised the health authority that clinicians should be reminded of the importance of carrying out a thorough physical examination and recording the patient’s medical history.

NHS Fife's Director of Nursing, Janette Keenan said: “We accept the Ombudsman’s findings in this case and have formally apologised to the individual for not having carried out a thorough physical examination or arranging an x-ray. The ombudsman did recognise that the condition is rare and unlikely to be diagnosed within an Accident and Emergency setting.

“The recommendations of the Ombudsman have since been implemented in full.”