Scottish Public Services Ombudsman

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  • Case ref:
  • Date:
    June 2014
  • Body:
    Ayrshire and Arran NHS Board
  • Sector(s):
  • Subject:
    clinical treatment / diagnosis
  • Outcome:
    Not upheld, no recommendations


Mrs C complained that the board unreasonably failed to diagnose the cause of her pain. Mrs C told us that she had experienced pain in her rib cage area since 2009 and had provisionally been diagnosed with gallstones. However, despite several hospital admissions, various tests and treatment, including the removal of her gall bladder, she remained in pain with no cause being identified. Mrs C said that the doctors treating her appeared to be accepting that her pain was unexplained and taking steps to help her cope with it, rather than seeking to diagnose the problem.

After taking independent advice from an adviser who is a specialist in pain management, we found that all the different specialists who had seen Mrs C had taken her concerns seriously and had carried out many appropriate investigations, including surgery, to determine the cause of her pain. When, however, a conclusive diagnosis for the root cause of it could not be made it was appropriate to shift the emphasis of treatment onto pain management and to refer her to a hospital pain clinic. Although Mrs C did not consider that the treatment she had received there addressed her pain, we considered it to be appropriate and in line with current medical practice. A decision to then refer Mrs C to a clinical psychologist had also been appropriate. Our medical adviser told us that there were no other investigations that the board should have reasonably considered to try to establish the cause of Mrs C's pain.

Download case 201302402 as a PDF (11.32 KB)

Updated: June 25, 2014