Decision Report 201601701

  • Case ref:
    201601701
  • Date:
    May 2017
  • Body:
    Lanarkshire NHS Board
  • Sector:
    Health
  • Outcome:
    Upheld, recommendations
  • Subject:
    clinical treatment / diagnosis

Summary

Mrs C, who works for an advocacy and support agency, complained on behalf of her client (Mrs A). She said that an orthopaedic consultant at Hairmyres Hospital should not have referred Mrs A for a Magnetic Resonance Imaging (MRI) scan because she had metal clips in her head from surgery performed in the past.

We took independent medical advice and found that MRI scanning should not be used in patients with metal clips as this can lead to movement of the clips in the strong magnetic field.

We considered that the orthopaedic consultant had not taken an adequate previous medical history when deciding to refer Mrs A for an urgent MRI scan. However, we noted that further safety checks by radiology staff prevented the scan from going ahead. We acknowledged that the board had apologised for the distress caused to Mrs A in relation to the referral but made two further recommendations.

Recommendations

We recommended that the board:

  • apologise to Mrs A for the failure to obtain her previous medical history at the time of the consultation and for inaccurately completing the MRI request form; and
  • draw these findings to the attention of the orthopaedic consultant for future learning.

Updated: March 13, 2018