Decision Report 201508148

Summary

Mr C complained about the time taken to diagnose the cause of his ongoing pain following a bone marrow biopsy at Hairmyres Hospital. About 12 months after the biopsy, Mr C was referred to orthopaedics at a different hospital and it was found that the pain was likely caused by damage to his sacroiliac joint (a joint in the pelvis). Mr C queried why he was not referred to orthopaedics or given an MRI scan sooner, and why he was not warned about the risk of ongoing pain before the biopsy.

The board considered staff took appropriate action to investigate Mr C's pain. They explained that they do not routinely warn patients of the risk of persistent pain from bone marrow biopsies as this is extremely rare, but they proposed to update their patient information leaflet in light of Mr C's experience.

After taking independent haematology (study of the blood) and radiology advice, we did not uphold Mr C's complaints. We found staff had taken reasonable action following the biopsy to investigate the cause for Mr C's pain, including a scan and treatment for signs of infection. When the pain persisted, staff treated this appropriately with medication and a referral to the pain clinic. While we acknowledged that an earlier scan would have been helpful to diagnose the cause of Mr C's pain, given that Mr C was undergoing chemotherapy and radiotherapy during this time which could have contributed to the pain, we considered it was reasonable for staff to wait until Mr C's cancer treatment was finished before referring him for further investigations.

We also found that, while persistent pain has been recognised as a complication from bone marrow biopsy, this is extremely rare. In view of this, we did not consider it unreasonable that staff did not warn Mr C about this risk.