Body:Lothian NHS Board - Acute Division
Outcome:Not upheld, no recommendations
Subject:clinical treatment / diagnosis
Miss C was admitted to the Royal Infirmary of Edinburgh with severe sudden onset headache. A lumbar puncture procedure (a medical procedure where a needle is inserted into the lower part of the spine to test for diseases in the brain, spinal cord or central nervous system) was carried out but the results were negative and she was discharged the following day. However, she subsequently suffered ongoing headaches and low back pain. She complained that she had not been advised long term pain was a possible risk of the lumbar puncture. She also complained about how the procedure was carried out, expressing unhappiness that it was carried out by a junior doctor and questioning what had gone wrong to cause her so much pain. She also asked what her long term prognosis was.
We took independent medical advice from a consultant physician. We found that an initial headache and back pain are recognised complications of lumbar puncture procedures, but that the pain usually settles within a few days and severe ongoing pain is rare. As such, we found that it would not be expected practice for clinicians to advise patients of a risk of long term pain. We did not uphold this aspect of the complaint.
In terms of Miss C’s long term prognosis, the adviser suggested it might be helpful for her to have her symptoms reviewed by a specialist and we suggested the board might consider offering a neurology appointment.
We found no evidence to indicate that there were any failings in the way the procedure was carried out that might reasonably explain Miss C’s ongoing pain. We also found that it is appropriate for junior doctors to carry out such procedures, under supervision, when they are at the stage of their training that the doctor who carried out Miss C's procedure was at that time. We did not uphold this aspect of the complaint.