Not upheld, no recommendations

Summary

Mrs C complained about her medical practice, specifically that they failed to recognise or suspect she had whooping cough given her symptoms until a blood test confirmed the condition. Mrs C told us that as a result of the failings, her health needs were not met and she posed an unnecessary risk to her family and other members of the public. Mrs C also raised concerns about the way the board handled her complaint in that a complaints manager had been involved in both supporting her and investigating her complaint.

We took independent advice from a medical adviser. We found that the standard of medical care and treatment provided was reasonable. We also found that, given the review of the investigation and report was undertaken by the head of services and not the complaints manager, the complaints handling was reasonable.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Mrs A). She complained that it was unreasonable for Mrs A's GP practice to fail to diagnose her with whooping cough until a blood test confirmed this. She also complained about communication with the GPs and the impact this had on the diagnostic process.

We took independent advice from a medical adviser who specialises in general practice. We found that the standard of medical care and treatment provided to Mrs A was reasonable, and that there was no evidence of any failings. We did not uphold the complaint.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Mrs A). Mrs A said that for a number of years she had been experiencing symptoms which had caused her concern. She attended her GP again because she had developed a rupture at her navel. Her GP made a referral for her to general surgery and she was given an appointment. However, before the appointment, Mrs A attended again at her GP and at the emergency department because of increasing abdominal pain. Her GP contacted the consultant surgeon asking if she could be seen sooner but she had already been given the first available appointment. At her hospital appointment, Mrs A was given a number of tests which showed likely peritoneal disease (disease of the lining of the stomach). After further tests, she was diagnosed with peritoneal mesothelioma (cancer that attacks the lining of the abdomen).

Ms C complained that Mrs A's GP had ignored the symptoms about which she had been complaining and that had she been referred to hospital sooner, she may have had an earlier diagnosis and her life expectancy may have improved. Mrs A complained to her medical practice, who said that she had not been a regular attendee at the practice and the majority of her symptoms had been respiratory for which she had received appropriate treatment. They added that when she presented with a hernia, she was immediately referred to hospital and that none of her symptoms had given any indication of her final diagnosis.

We took independent GP advice and found that all of Mrs A's symptoms had been investigated and treated appropriately. There had been no delay in referring her to hospital and there had been no suspicion of a cancer diagnosis to which a reasonable GP would have been alerted. We did not uphold the complaint.

Summary

Mrs C complained about the care and treatment her late husband (Mr A) received from his medical practice. She said that over an eight week period, staff at the practice failed to provide her husband with appropriate clinical treatment in view of his reported symptoms. Mrs C said her husband was subsequently diagnosed with terminal lung cancer and died shortly after. Mrs C complained that the practice failed to look at, examine and listen to her husband. She complained that they were dismissive and that they took too long to recognise how ill he was. She said her husband had a past diagnosis of cancer and that this should have alerted the practice to the possibility of a return of the cancer.

We obtained independent advice on the case from a GP. We found that the care and treatment the practice provided to Mr A was appropriate. We found that Mr A's medical records did not evidence any failure in taking his history or in examining him, that Mr A's investigations and referrals were of a reasonable standard and there was not any significant delay in these being carried out.

The adviser did not consider that a history of treated cancer 37 years earlier should have alerted the practice to consider an alternative diagnosis in Mr A's case. We found that Mr A's chest x-ray, taken in hospital approximately six weeks after Mr A first attended the practice, was normal with no evidence of lung cancer. We found his case records did not contain evidence of him reporting red flag symptoms or signs to either the GP or to the hospital doctor.

We concluded that the practice did not fail to provide Mr A with appropriate clinical treatment in view of his reported symptoms and we did not uphold Mrs C's complaint.

Summary

Mr C complained to us that the medical practice had failed to provide appropriate care and treatment to his late wife (Mrs A). He said that Mrs A died from cancer and that he requested a copy of her medical records from the practice. He noted that two years prior to his wife's death she had attended the practice with an eight week history of abdominal pain. He had checked the National Institute for Health and Care Excellence (NICE) guidance and this said that a CA125 blood test (a test used to diagnose ovarian cancer) should have been carried out. The blood test was not performed at the first consultation. Mr C felt that his wife had met the criteria for the test and had it been carried out, it may have identified her cancer earlier. He also said that his wife attended the practice 12 months later and again the CA125 blood test was not taken.

The guidance states that clinicians should carry out tests if a woman (especially if 50 or over) reports having any of a number of symptoms on a persistent or frequent basis (particularly more than 12 times per month). Abdominal pain is one of the stated symptoms. We took independent GP advice and found that at the first consultation, the practice had provided a reasonable level of care. It was recorded that Mrs A had reported an eight week history of right sided abdominal pain and tiredness with no change in bowel habit. Antibiotics were prescribed along with blood tests (not including CA125) with a further review. The adviser said that it was not a failing in care not to have requested a CA125 blood test as the guidance does not define 'persistent or frequent basis' in terms of length of time of having symptoms. Although Mrs A was over 50 and had symptoms for eight weeks, the guidance does not specifically state that a CA125 blood test is required in such a situation. We did not uphold the complaint, but highlighted that it would have been best practice for Mrs A to have been asked to return if her symptoms persisted following the course of antibiotics.

Summary

Mrs C complained about the care and treatment provided to her late niece (Miss A) by the practice. Miss A had reported gynaecological symptoms and after examinations and tests, she was diagnosed with an infection. Miss A received treatment for this, however, a few months later, she reported similar symptoms. She was seen on a number of occasions and provided with treatment. When her symptoms persisted, a referral was made to the local gynaecology department and a scan was arranged. Miss A was later diagnosed with cervical cancer following an emergency hospital admission. Mrs C complained that, given the level of contact Miss A had with the practice, she had not received appropriate care for her reported symptoms.

After taking independent advice from a general practitioner, we did not uphold Mrs C's complaint. We found that Miss A had had an infection and that the symptoms she reported later were consistent with infection or complications of an infection. The advice we received was that it was reasonable to consider that her symptoms were due to infection and that the practice had arranged appropriate tests and referrals for Miss A.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Ms A). She said there had been a delay in Ms A's medical practice making a referral for her to attend the orthopaedic department when her back problems continued. She further said that the practice failed to follow up on the referral when it was eventually made. While the practice recognised that Ms A felt unsupported, they nevertheless said they had been appreciative of Ms A's difficulties and had tried to help her.

We took independent medical advice from a GP. We found that while Ms A attended the practice prior to her referral, the medical records showed that she had been treated reasonably, that her condition had been monitored, that she had been appropriately examined, and that she had been prescribed medication in accordance with her symptoms and published guidance. There were no 'red flags' (signs to warrant urgent referral).

Although we found that the practice did not issue the referral immediately, once the error was discovered it was issued and sent within the time-frame required by local guidance. An apology had been given to Ms A for the oversight. We did not uphold Ms C's complaint.

Summary

Mr C complained about the care and treatment he received when he attended at the board's out-of-hours service at the New Victoria Hospital. Mr C had been suffering from abdominal pain, nausea, vomiting and fever. He saw a GP on his first attendance and although Mr C had suggested he might have appendicitis, the GP dismissed this and felt it was viral gastroenteritis. Mr C was sent home after having an injection for the nausea. The pain continued and Mr C re-attended the out-of-hours service three days later and saw another GP. The GP thought Mr C was suffering from trapped wind and gave a further injection and told Mr C to return home. He did so but returned to the same GP two hours later as the pain had not settled and he was then referred to hospital for a specialist opinion. The hospital then diagnosed that Mr C had appendicitis where he was required to undergo emergency surgery. Mr C felt that the GPs at the out-of-hours service had failed to take his concerns seriously and that he should have been referred for a specialist hospital opinion sooner.

After taking independent medical advice, we did not uphold Mr C's complaint. The advice we received was that the examinations carried out by both GPs were reasonable with appropriate advice and treatment being provided on the basis of the findings. The adviser explained that Mr C had not shown any of the classical signs of appendicitis at the time of the first two examinations and that it was appropriate to refer him to the hospital specialists on the third attendance as his clinical condition had worsened.

Summary

Ms C complained about the care and treatment she was given by a consultant surgeon after her GP made an urgent referral for her to attend the board's breast service. She said that her appointment took too long to be arranged after referral and then the examination given had been brief. She believed that she should have been sent for a mammogram because of her presenting symptoms and her reported family history. Ms C complained that by the time she was diagnosed with breast cancer, she required a full mastectomy. The board considered that she had been treated reasonably and appropriately in terms of the relevant protocol. Ms C remained unhappy and complained to us.

We took independent advice from a consultant breast surgeon and we found that when Ms C presented initially, there was no need to perform a mammogram and she was appropriately examined and investigated. Five months later, after being urgently referred, Ms C was examined and had a mammogram and ultrasound imaging with biopsies taken. She was diagnosed with an invasive form of breast cancer for which she was given chemotherapy and then a mastectomy.

We found that Ms C's treatment had been reasonable, appropriate and timely, in accordance with Scottish Government targets. For these reasons, we did not uphold the complaint.

Summary

Mr C, who works for an advocacy and support agency, complained on behalf of his client (Mrs A). Mrs A complained about the care her late son (Mr A) received at Queen Elizabeth University Hospital after he was taken there by emergency ambulance. It was identified that Mr A was suffering from limb and life threatening ischemia (a lack of blood supply that could be life threatening or cause the loss of a limb) requiring urgent surgery. Mrs A complained that the board's consultant vascular surgeon did not share this information with the family in a more private area of the hospital, that there was a lack of action by staff in response to Mr A having complained of severe stomach pain following surgery, and that Mr A had been placed in a single room containing equipment prior to his death a few days later.

We took independent advice from a consultant vascular surgeon. We found that, although the cubicle environment in the emergency department was not ideal, the communication that took place with Mr A and the family was reasonable and we did not uphold this complaint. We also considered that there was no undue delay in carrying out a scan following the surgery after Mr A's concerns about his stomach pain were identified. We did not uphold this complaint. We further identified that the board had reflected on the family's concerns about there being equipment stored in the single room due to essential maintenance work. They acknowledged that this should have been explained to the family at the time and they apologised for this. We concluded that it was not unreasonable to transfer Mr A to the single room to allow the family more privacy, and on balance we did not uphold this complaint.