Overview
The complainant (Mrs C) complained about the treatment provided to Mr A, after he was admitted to the Aberdeen Royal Infirmary (the Hospital) with severe chest pain. Mr A was initially treated as having acute coronary syndrome (a medical term used when doctors believe that the patient has a serious problem with the narrowing of one or more of the coronary arteries) because of an elevated serum troponin (this is present in the bloodstream when there has been damage to the heart). However, approximately two and a half days after his admission, it was diagnosed that Mr A had a dissection flap (tear) in the ascending aorta (a portion of the large trunk artery that carries blood from the left ventricle of the heart to branch arteries). Arrangements were made for Mr A to undergo surgery that day, but he died in the anaesthetic room before the operation could begin.
Specific complaint and conclusions
The complaint that has been investigated is that staff at the Hospital failed to provide Mr A with an appropriate level of treatment following his admission in January 2012 (upheld).
Redress and recommendations
The Ombudsman recommends that the Board:
- issue a written apology to Mr A's family for: the failure to identify that Mr A had aortic dissection when the bedside echocardiogram was carried out on 2 January 2012; and the delay in providing a copy of the bedside echocardiogram to his office; and
- provide evidence that they have taken steps to raise awareness of aortic dissection in their A&E, Emergency Medicine, General Medicine and Cardiology departments.
The Board have accepted the recommendations and will act on them accordingly.