Decision Report 201910152

  • Case ref:
    201910152
  • Date:
    January 2022
  • Body:
    Fife NHS Board
  • Sector:
    Health
  • Outcome:
    Not upheld, no recommendations
  • Subject:
    Clinical treatment / diagnosis

Summary

C complained that the board failed to investigate, diagnose and treat gastrointestinal (relating to the stomach and intestines) problems and swallowing difficulties that they had experienced over a number of years. As a result of previous abuse, C required invasive procedures to be carried out under general anaesthetic. C complained that the board placed unreasonable emphasis on their trauma when making decisions about their treatment.

We took independent clinical advice from a consultant in gastroenterology (medicine of the digestive system and its disorders) and hepatology (liver disease). We considered C's initial treatment plan to be reasonable: a CT scan of C's colon followed by an upper GI endoscopy (a medical procedure where a tube-like instrumentis put into the body to look inside) as recommended by the private clinic that they attended, and a colonoscopy (examination of the bowel with a camera on aflexible tube) if indicated by the results of the CT scan. We found that the decision not to carry out a colonoscopy at this stage was reasonable, given the risks of performing this under general anaesthetic and the previous normal investigations.

We were critical of the board's failure to offer C a flexible sigmoidoscopy (an imaging test done to monitor the colon and rectum for the presence of ulcers, polyps or other abnormalities) after they developed rectal bleeding, but noted that this did not impact on C's overall treatment plan. C had gone on to have a colonoscopy under a different NHS board, which did not identify any significant pathology.

We did not consider the emphasis placed on C's childhood trauma to be excessive and we noted that reasonable investigations were carried out into C's swallowing difficulties.

Therefore, we did not uphold this complaint.

With regard to C's complaint that the board's complaint response contained inaccurate information, we found that generally their response was thorough and detailed. With the exception of an incorrect reference to C having anaemia, we found that the board's response to be factually accurate with clear explanations as to what investigations had been carried out and why. We did not uphold the complaint.

Updated: January 19, 2022