Rubino v Ziaree  ACTSC 331 (on AUSTLII).
The plaintiff sued his general practitioner in relation to treatment and management of a hyperkeratosis on his right foot over a three year period. Following a number of consultations the GP referred the plaintiff to a surgeon through the public health system in the ACT. It was alleged that the GP did nothing further and failed to follow up the referral. The plaintiff’s foot ultimately became infected and required surgery, leaving the plaintiff with an antalgic gait, pain and difficulty walking.
The defendant’s evidence was that the plaintiff told him he was on the waiting list for surgery. The plaintiff’s version of events was that he went back to see the defendant at the Practice on multiple occasions between early 2014 and 2016 and that he told the defendant he had not heard from the surgeon and that he was in considerable and consistent pain. On one occasion he even asked the defendant for the phone number of the surgeon so that he could call and follow up the referral himself. The defendant gave the plaintiff a phone number, but when the plaintiff called the number, it reached the cardiac clinic at Canberra Hospital. The Court accepted the plaintiff’s evidence, which was consistent with what he told a podiatrist.
The Court found that if no response to the written referral had been received after 3 months a reasonable practitioner in the circumstances would have followed up to find out what was happening, whether by telephone or in writing. A reasonable general practitioner would also have followed up on what the patient had been doing to improve the condition of the foot. This should have included discussing steps the patient could take that did not need a referral, such as attending a podiatrist. ( – ). A reasonable general practitioner would have made enquiries of the hospital as to the expected timing of a consultation to confirm surgery was required, or if it was assumed such consultation had happened, whether any information that could be provided as to the timing of the surgery. ().
The Court held at  that the referral pathway, in terms of ensuring the plaintiff had access to specialist advice, was not managed with due care and skill. I accept there was a failure to ensure the plaintiff received specialist surgical treatment in a timely manner, including following up in relation to the referral that had been issued.
The Court also held that the plaintiff would have followed the specialist advice and whichever way the problem was addressed would have allowed the plaintiff to work with an improved level of physical movement and without significant pain ().