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The duty of a general practitioner to follow up referrals

The recent decision in Rubino v Ziaree highlights the importance of general practitioner duties to follow up on referrals they have provided to their patients. Mr Rubino successfully sued his general practitioner, Dr Ziaree, for failing to follow up on a referral for specialist treatment between 2014 and 2016.

Mr Rubino suffered hyperkeratosis (also know as a “corn”) on his right foot over a three-year-period. In summary:

  • Mr Rubino alleged that between July 2013 and 9 August 2016, he saw Dr Ziaree on about 19 separate occasions in relation to his foot condition.
  • In 2014, Dr Ziaree referred Mr Rubino to a surgeon in Canberra through the public health system.
  • Mr Rubino gave evidence that he was told by Dr Ziaree that he needed to see a surgeon and that the surgeon would be in contact with him. Mr Rubino said that he was never contacted by a surgeon or anyone at Canberra Hospital in relation to being placed on a wait list for surgery.
  • Mr Rubino also gave evidence that he saw Dr Ziaree on multiple occasions and told him that he had not heard from the surgeon. On one occasion he asked Dr Ziaree for the surgeon’s number so that he could call and follow up the referral himself. However, when Mr Rubino called, it reached the cardiac clinic at Canberra Hospital.
  • In about August 2016, the condition of Mr Rubino’s right foot deteriorated and he was diagnosed with an infection. About a week later he had unbearable pain despite taking endone, and described the lump on his foot as being the size of his hand.
  • Mr Rubino was admitted to Canberra hospital for emergency surgery to drain an abscess of the right foot abscess. He underwent a further procedure for debridement and washout of the right foot abscess.
  • Mr Rubino argued that “the standard of care owed by a reasonably skilled practitioner involved devising, implementing and maintaining an effective treatment plan with regard to the…complaint, which included referring him for specialist surgical treatment, and following up any such referral”.
  • As a result of the negligence, Mr Rubino alleged that he suffered antalgic gait, difficulty walking and pain. Mr Rubino also suffered a somatic symptoms disorder and an adjustment disorder with depressive mood.

The Court found in favour of Mr Rubino and held that a reasonable general practitioner would have followed up the referral after three months of no response. Mr Rubino was awarded a total of $184,645.00 in compensation, plus expenses repayable to Medicare.

You can read the full decision here

Our firm has successfully acted for clients in claims against general practitioners and is available to assist you with initial advice for medical negligence.

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