Scottish Public Services Ombudsman

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  • Case ref:
  • Date:
    January 2016
  • Body:
    Ayrshire and Arran NHS Board
  • Sector(s):
  • Subject:
    clinical treatment / diagnosis
  • Outcome:
    Not upheld, no recommendations


Miss C complained that the board failed to provide appropriate medical treatment when she attended Crosshouse Hospital with a knee injury. At the hospital, she had been reviewed by the on-call doctor for orthopaedics (the medical specialism for conditions involving the musculoskeletal system). The doctor arranged for her to attend a knee clinic three days later. We took independent advice from a medical adviser, who is a consultant orthopaedic surgeon. We found that it had been appropriate to refer Miss C to the knee clinic and that this appointment had been arranged promptly. Consequently, we did not uphold this aspect of Miss C's complaint.

Then, six days after attending the hospital, Miss C had an operation on her knee. Afterwards, she continued to have pain and stiffness in her knee. She was referred to a physiotherapist, and for tests to check if she had a blood clot in a vein. She then saw the orthopaedic surgeon who had carried out the operation. The surgeon was concerned that Miss C might have complex regional pain syndrome (CRPS - an uncommon form of chronic pain, usually affecting a limb and typically developing after an injury, surgery, stroke or heart attack; the pain is out of proportion to the severity of the initial injury). The surgeon prescribed medication and referred Miss C for more physiotherapy. When this failed to improve things, the surgeon decided that Miss C had CRPS and referred her to a pain clinic and for hydrotherapy (the use of water in pain relief and the treatment of disease). However, Miss C decided to attend a private hospital and subsequently had further surgery. She complained to us about the treatment she received from the board in the months after her initial operation.

Based on the advice we received, we found that Miss C's operation was carried out satisfactorily and that her follow-up appointments were timely, appropriate and reasonably managed. We also found that the board had carried out adequate investigations regarding the pain and stiffness in Miss C's knee. Therefore, we did not uphold this aspect of her complaint.

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Updated: January 20, 2016