vomiting and dizziness and the presence of an umbilical hernia.

vomiting and dizziness and the presence of an umbilical hernia. He was constipated. That same Sunday evening he vomited copiously and a facsimile request was sent seeking review by his doctor on the following day. On 25 February Mr Biffin’s general practitioner Dr Lambie attended and examined and assessed Mr Biffin. Dr Lambie concluded Mr Biffin’s symptoms were due to an umbilical hernia and constipation. He said he considered and excluded the possibility that Mr Biffin was suffering from an obstructed bowel and he reduced the hernia. He packed and taped the hernia orifice. He noted on the record a direction to administer Movicol for constipation. He gave brief verbal instructions to contact him if Mr Biffin’s condition deteriorated or he had abdominal pain or vomiting occurred. Subsequently there was no record of complaint of pain or vomiting but Mr Biffin’s overall condition deteriorated until his final collapse immediately following vomiting at about 23:15 on 26 February 2013.

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