• Case ref:
  • Date:
    October 2013
  • Body:
    A Medical Practice in the Orkney NHS Board area
  • Sector(s):
  • Subject:
    clinical treatment / diagnosis
  • Outcome:
    Not upheld, no recommendations


Mr C sustained head injuries in a road traffic accident. He went to hospital where his wound was dressed and he was advised to take painkillers. He attended his medical practice the following day for a change of dressing. Several days later he saw another GP who arranged for a nurse to rebandage his wound. He said that it was found to be dirty with glass fragments left in it. Mr C complained about the way his GPs managed his wound. He was also concerned about how one of the GPs managed his subsequent headaches and said he should have been referred for further investigation earlier. Finally, Mr C said that the follow-up by nursing staff, rather than his GP, was not reasonable.

We took independent advice from one of our medical advisers. They said that wound management is a nursing responsibility and that the management and follow-up was appropriate for this type of injury. In relation to the glass fragments, the adviser said these were unlikely to have caused complications and would have worked their way to the surface. It was, therefore, reasonable to allow this to happen and to treat Mr C with antibiotics rather than try to remove fragments, which might have damaged the healing process. In relation to how the practice managed Mr C's headaches, the advice was that further investigations and treatment were provided within a reasonable time, although the GP did not record information about one of the consultations. Having said that, we found that the care and treatment provided overall was of a reasonable standard.