Mr Aloke Singhania 2017-06-14 Person 1 5 0

I saw Dr Aloke Singhania on 24th September 2012, urgently at a cancellation appointment, following a referral dated 21st September 2012 signed by my GP Dr Alisdair Macnair. I asked Dr Singhania to review my left knee. And also my swelling in the right leg, following a diagnosed pulled muscle a month earlier (visual examination only, diagnosis by Dr Sarah Cowen at NHS Addenbrookes A & E 26/8/12). Dr Aloke Singhania noted 'tremendous oedema' and over the course of 11 days, he ruled out a fracture and a tear, by x-ray and MRI of the lower limb. The left knee was not investigated, due to a paperwork error - the wrong knee was scanned by the Bupa hospital, in spite of my advising of the mistake prior to the scan being performed. The left knee had been included in the referral as my right leg was useless following pallor, cold useless limb, and unbearable pain, shortness of breath, over a week earlier. I had been phoning my GP and NHS Direct, several times daily, writing to PALS at the local hospital to ask for access to medical help, trying to access help, for several weeks. Without success. On the 11th day under his care, 5 1/2 weeks after onset, Dr Singhania ordered an ultrasound. No injury was found. however when asked for my opinion by the radiographer, I mentioned family history of DVT, and a DVT was found within 30 seconds, around 1/3 u the right thigh. Apparently a second DVT was found, higher up. Dr Singhania then gave me warfarin and heparin and told me to get a warfarin prescription from my GP the following day. There were failures in care: Dr Singhania had an exceptionally unhelpful PA, who advised that my GP had been formally advised that my anticoagulation for 3 months should be overseen by NHS, in writing. But that record is not on my GP records, nor on my hospital records. The only record is Nurse Tina Sleep signing Dr Aloke Singhania as being in charge of my anticoagulation for 3 months duration. And the PA to Dr Singhania, email informing me that communication had been done was sloppily written and unprofessional. Consequently I was assigned by Nurse Tina Sleep to have my anticoagulation warfarin therapy overseen by Dr Aloke Singhania, Hip and Knee Orthopaedic Surgeon, for anticoagulation for 3 months between October 2012 and January 2012, without being able to access that care. Neither my GP, the hospital, nor my MP were able to resolve: so I was left being treated with warfarin, without any consultant or specialist nursing, supervision - aside from INR blood tests sent off by my GP surgery. However my GP Nurses were not at all knowledgeable, and they didn't know how I was meant to stop taking warfarin - by tapering or simply stopping, when I received a hospital letter telling me to 'stop taking warfarin unless your GP/hospital doctor has advised otherwise'. Dr Singhania refused to respond to any communications about my care after October 2012, whilst I was officially under his care for anticoagulation. I think that if Dr Singhania replaces his PA, with a trained, professional, assistant, it would likely improve the quality of his professional care. Otherwise, he seemed a moderately competent chap - albeit one who failed to immediately rule out a DVT in a symptomatic patient, and which could have resulted in a fatality in the 11 days without access to a d-Dimer, or ultrasound, in his care pre-diagnosis. My understanding is that by reputation, professionally, for patients who do need knee and hip surgery, he is likely to be competent - though the fact that the wrong knee was MRI scanned, and that there was a refusal to correct. The fact that error was not formally acknowledged in spite of the left limb being specified on a document faxed to his PA prior to the appointment, for which i have a fax receipt, means that I would be very wary about whether he operates on the correct knee/hip. I would be more confident if the error had been corrected as soon as advised, pre-scan, or even post-scan, the correct knee being scanned to remediate the error. - But a failure to acknowledge and correct the mistake, sets a precedent that the same denial rather than correction could happen where a surgery is carried out on the wrong limb.