Not upheld, no recommendations

Summary

Ms C complained about her daughter's (Miss A) primary school. Miss A had recognised issues at primary school, particularly with her emotional literacy and communication skills. She also reacted badly when she made mistakes. Her head teacher had discussed these issues with Ms C and steps were agreed to help Miss A. However, her problems continued and the head teacher referred the matter to social work in terms of the Scottish Government's 'Getting It Right For Every Child' (GIRFEC) procedures. Ms C complained to the council that the head teacher discriminated against her and that the council were unreasonable in the way they dealt with her complaint.

We investigated Ms C's complaint and made further enquiries of the council. We found that GIRFEC procedures are the national approach to improve outcomes for, and to support the wellbeing of, children by offering the right help at the right time. The child is the focus for all organisations involved and the approach encourages early intervention by professionals, for instance, by social work who could provide help to avoid crisis situations at a later date. Miss A had some problems which were not resolving, although her school had involved Ms C in their efforts to help her. Accordingly, the head teacher approached social work in line with GIRFEC guidance. While Ms C considered this to be unreasonable, we found no evidence of this. We did not uphold her complaint. Although Ms C also complained about the way the council later considered her complaint, she was unhappy with the merits of the decision rather than the way the decision on her complaint had been made. We did not uphold this complaint.

Summary

Mr C complained about the care and treatment provided to him by his dentist. Mr C attended his dentist after experiencing pain in his teeth. After taking x-rays and performing an examination, the dentist considered there was an abscess around the roots of a tooth supporting the bridge in Mr C's mouth. When Mr C re-attended to discuss this, the dentist documented offering options including an extraction. Some weeks later, the extraction was performed.

Mr C said he was persuaded to have the extraction and questioned whether this was appropriate treatment. He also said the dentures he was provided with were uncomfortable and ill-fitting. He said he told the dentist that he ground his teeth, and that the dentist offered a bite shield, which was not provided.

After obtaining independent advice from a dentist, we did not uphold Mr C's complaints. We found that there was evidence of options being discussed in the dental records, and consent to treatment. We found the treatment option of an extraction was reasonable in the circumstances. We considered the dentist provided appropriate advice about the dentures and the need to have them re-fitted. We noted that a bite shield would not usually be provided until the condition of a patient's teeth was stable.

Summary

Ms C complained that her dentist failed to give her appropriate treatment. In particular, she complained that the dentist may have fractured the root of her tooth during root canal treatment.

During our investigation we took independent advice from a dental surgeon. The adviser said that a root canal was the appropriate treatment for Ms C's tooth, and found that the root canal had been carried out appropriately, with Ms C's root fracture happening over a year later. We, therefore, did not uphold the complaint.

Summary

Mr C complained about the care and treatment his late wife (Mrs A) received at Monklands Hospital. Mrs A attended the A&E department at the hospital and was diagnosed with a urinary tract infection. She was sent home with antibiotics and instructions to return if she still felt unwell. Mrs A returned the next day and was admitted for further investigations. Scans showed Mrs A had a large mass in her pelvis, hydronephrosis (an obstructed kidney) and pulmonary emboli (blood clots in her lungs). She was treated by urology doctors for the kidney problems, and then by gynaecologists for the mass in her pelvis, which was found to be cancerous. Mrs A was offered surgery roughly two weeks after her admission, but it was not possible to remove the cancer. Mrs A was given palliative care and died in hospital.

Mr C complained that Mrs A was not admitted when she first attended hospital, and that it took too long to diagnose Mrs A's cancer and offer her surgery. Mr C was concerned that gynaecologists did not review Mrs A until a week after her admission, and then waited for the multi-disciplinary team meeting around a week after that before making a decision about treatment.

The board responded to Mr C's complaint in writing and offered to meet with him if he wished. They explained that they considered the treatment provided was appropriate.

After taking independent emergency medicine and gynaecology advice, we did not uphold Mr C's complaints. We found that the treatment provided when Mrs A first attended hospital was appropriate, and that it was reasonable to offer antibiotics first with instructions to return if her symptoms continued. We also found the time-frame for diagnosing and treating her cancer was reasonable. While Mrs A was not reviewed by gynaecologists until a week after admission, gynaecologists discussed her condition with the doctors caring for her, and requested further tests to diagnose the mass, which were carried out before the gynaecology review. We also found that it was appropriate to wait for the multi-disciplinary team meeting before deciding on treatment, given the complexity of Mrs A's case.

Summary

Mrs C complained that the board unreasonably failed to provide appropriate clinical treatment following her decision not to agree to a lumbar puncture procedure (a procedure where a needle is inserted into the lower part of the spine to test for conditions affecting the brain, spinal cord or other parts of the nervous system).

Mrs C was referred to a neurologist at Raigmore Hospital as she was experiencing a range of neurological symptoms. The neurologist conducted an examination, but made no definite findings. Mrs C advised that she did not wish to have a lumbar puncture. A range of scans were subsequently performed, but no definitive diagnosis was reached. Mrs C was subsequently seen by a second neurologist, who again raised the possibility of the lumbar puncture. Further scans were performed, however no definite diagnosis was reached over the course of approximately one year.

Mrs C raised a number of concerns, including that she was repeatedly pressured to have the lumbar puncture, that blood tests were not performed timeously, and that she had received inconsistent information from the two neurologists about her condition and the results of scans. The board considered that the care and treatment provided had been appropriate.

We took independent advice from a neurologist. We did not find evidence in the medical records to suggest that the neurologists acted inappropriately in offering the lumbar puncture. We found it would have been good practice for the blood tests to have been performed, but noted this was usually done before a patient would be seen by a neurologist. We found that the information provided to Mrs C about the scans and her condition was of a reasonable standard, given the complexity of her case, and that there were different views among the radiologists who reviewed the scans. On balance, we did not uphold Mrs C's complaint.

Summary

Mrs C complained to us on behalf of her husband (Mr A) about dental treatment he had received from the practice. Mr A went to his dentist regarding a tooth that was causing him pain. The tooth was x-rayed and subsequently filled. Mr A experienced severe pain overnight after having the filling, and booked an emergency appointment for the following day. At the appointment, Mr A was seen by a different dentist. The dentist performed an extraction of the tooth. Mr A complained to the practice and said that he did not consent to having his tooth extracted. Mr A said he had discussed with his previous dentist that if the filling was not effective, then a root treatment would be the next course of action. Mr A said he would not have wanted his tooth extracted because there was already a missing tooth next to it. Mr A also complained that he had been told the level of bleeding he experienced was normal and he did not agree with this.

We took independent advice from a dentist and found that the dental records indicated that the dentist did consult with and obtain consent from Mr A. The adviser also confirmed that Mr A was correctly advised regarding bleeding. As a result of Mr A's complaint, the practice have included the extraction of wisdom teeth in the list of procedures that require written consent. Our investigation found that the practice did not fail to obtain consent to extract Mr A's tooth and that they correctly advised him regarding the level of bleeding following a tooth extraction. We therefore did not uphold the complaints.

Summary

Mr C complained about the care and treatment provided to him at the A&E department of Queen Elizabeth University Hospital. Mr C said that when he attended with chest and back pain and shortness of breath he was told he was suffering from muscular pain and given painkillers. Mr C attended again two months later and was diagnosed with pulmonary embolism (PE - a blockage of the artery that carries oxygen between the heart and lungs). Mr C complained that he had not been properly assessed on his first attendance and that the doctor had focused on the fact that he had been to the gym the night before. He said that he felt the diagnosis of PE was missed and that the delay may have led to permanent damage.

During our investigation, we took independent advice from an A&E consultant. We found that the diagnosis of muscular pain made when Mr C first attended A&E was consistent with his reported symptoms and the observations carried out. The adviser said that whilst there appeared to have been some small areas of moderate damage to Mr C's lungs, it was not possible to state that this was due to a failure to diagnose him with PE at an earlier point. We did not uphold Mr C's complaint.

Summary

Miss C complained about the care and treatment provided to her mother (Mrs A) at Queen Elizabeth University Hospital. Mrs A was admitted with back pain and faecal incontinence and was discharged after three days. Two days later, Mrs A was admitted to another hospital where she died three days after her admission. Miss C complained that her mother's discharge from Queen Elizabeth University Hospital had been inappropriate.

We took independent advice from a consultant orthopaedic surgeon, a consultant neurosurgeon, and a consultant gastroenterologist. The advice we received from the orthopaedic adviser was that the orthopaedic team caring for Mrs A had carried out all reasonable and appropriate tests and investigations during her admission, which included obtaining advice from the neurosurgery team. Mrs A had been assessed appropriately before discharge to ensure it was safe for her to go home.

The neurosurgery adviser did not identify any failings on the part of the neurosurgery team in the advice they gave to the orthopaedic team.

We also sought advice from a gastroenterology consultant, given that Mrs A's liver function test results were found to be abnormal. The advice we received was that the test results had been discussed appropriately with Mrs A's GP. It was established they had not worsened since previous tests and an out-patient referral had already been arranged. The decision to discharge Mrs A was reasonable.

Taking account of the evidence and the advice we received, we did not uphold Miss C's complaint.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Mr A) about the care and treatment provided by the practice to his late wife, (Mrs A). Ms C complained that the practice missed an opportunity to diagnose Mrs A with pancreatic cancer and that they failed to send her for a scan.

During our investigation, we took independent advice from a GP adviser. We found that the symptoms Mrs A had presented with were not consistent with pancreatic cancer and, therefore, there was nothing that would alert the practice to the need to arrange further investigations or scans. Therefore, we did not uphold Ms C's complaint.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Mr A) about the care and treatment provided by the board to his late wife (Mrs A). Ms C complained that there was an avoidable delay in the board diagnosing Mrs A with pancreatic cancer and that there was a delay in carrying out a scan.

During our investigation we took independent advice from a medical adviser. We found that the actions of the board had been reasonable and that there was no delay in the diagnosis of pancreatic cancer as Mrs A had not been presenting with symptoms which would alert clinicians to a suspicion of this diagnosis. We also found that it was reasonable that a scan was arranged on an out-patient basis and there was no undue delay in carrying out the scan. Therefore, we did not uphold Ms C's complaint.