Decision Report 202410876

Summary

C complained about the care and treatment provided to their adult child (A). A has hereditary haemorrhagic telangiectasia (HHT, a rare genetic disorder characterised by abnormal blood vessel formation, leading to frequent bleeding, with potentially severe complications). A attended A&E as they had previously been bleeding from the left eye. A was triaged within 30 minutes and seen by a senior nurse within 90 minutes. The senior nurse discussed A’s presentation with a senior doctor. A was advised that they could await clinical review by a doctor, with a likely wait of up to two hours. A decided to leave and see an optician the next day. A was subsequently referred to the ophthalmology department (eye specialists) for further review and then to the oculoplastic clinic (specialists in surgical procedures around the eye) to consider cauterisation of a lesion inside the left, lower lid.

C complained that triage and initial review were unreasonable, as no-one examined A’s eyes or nose, staff had little understanding of the condition, on-call ophthalmology were not consulted and A felt pressured to leave. Overall, C was concerned that A could have lost their sight without timeous, specialist intervention.

The board considered that A had been appropriately managed in A&E. They noted that the discharge letter advised A had no active bleeding and no visual disturbance. A was offered to wait for medical review but decided to make their own optician appointment.

We took independent advice from a consultant in emergency medicine. We found that triage and staff understanding of A's condition was reasonable. We found that it was reasonable to give A the opportunity to await clinical review and not to have ophthalmology input prior to clinical review. No harm came to A and no adverse event review was required. We did not uphold C's complaint.