Not upheld, no recommendations

Summary

Mr C said that although he attended his medical practice concerning his back pain on a number of occasions over a period of two months, doctors failed to note his deteriorating condition. He said that he was given increasingly strong painkillers which failed to work and that although he was exhibiting 'red flag' symptoms, he was not referred for further investigation or imaging. Mr C said that it was not until he attended with his son that he was taken seriously and admitted to hospital as an emergency. He required an immediate operation.

Mr C complained to the practice who said that while they noted that he was in significant pain, Mr C did not show any symptoms or clinical signs that would have triggered an immediate referral for surgery (there were no red flags). They believed that he had been treated appropriately and in accordance with guidance.

We took independent advice from a GP and found that the practice had carried out appropriate examinations. Mr C's pain was regularly reviewed and his painkillers were increased accordingly. They repeatedly checked Mr C for red flag symptoms and an appropriate referral was made for him when his symptoms changed. We therefore did not uphold Mr C's complaint.

Summary

Ms C complained about the care and treatment provided to her mother (Mrs A) by her GP practice. A GP visited Mrs A's home and following an examination, the GP considered that Mrs A had an upper respiratory tract infection. Her condition did not improve following the GP's visit and her family took her to hospital. Further examinations in hospital identified that Mrs A had pneumonia, and she died a number of days following admission.

Ms C raised a number of concerns about the home visit carried out by the GP, and felt that an x-ray should have been arranged and antibiotics prescribed. We took independent GP advice and found that the GP's assessment was reasonable. We noted that the GP had documented a detailed history and examination of Mrs A, and that their observations were consistent with a viral infection such that antibiotics were not necessary at that time. The adviser also said that there was no clinical indication for a chest x-ray as Mrs A's symptoms and signs were not consistent with a likely diagnosis of pneumonia. The adviser noted that the GP had also provided advice on what to do if Mrs A's condition became worse. Overall, we found that the GP had provided reasonable care and treatment. We did not uphold this aspect of the complaint.

Ms C also expressed concern that the GP failed to arrange hospital admission given Mrs A's symptoms. While we noted that Mrs A was subsequently admitted to hospital where she was diagnosed with pneumonia, the adviser did not consider that Mrs A's recorded symptoms at the time of the GP visit were consistent with pneumonia, and did not consider that there was an indication that Mrs A needed to be admitted to hospital at this time. We did not uphold this complaint.

Summary

Mrs C complained to us that that the board had delayed in diagnosing that she had Crohn's disease (a long-term condition that causes inflammation of the lining of the digestive system). Mrs C had significant symptoms of abdominal pain, diarrhoea and significant and progressive weight loss and had undergone a number of tests arranged by the board in relation to this. No diagnosis was made and Mrs C asked for a second opinion. She was referred to Wishaw General Hospital. Further tests were carried out, but it was not considered that there was evidence to support a diagnosis of Crohn's disease. Mrs C then attended a private hospital, where a diagnosis of Crohn's disease was made. Mrs C told us that a surgeon at the private hospital looked at a scan carried out at Wishaw General Hospital and found that it showed she had an abnormality in her bowel, which had not been identified by the board.

We took independent advice from a gastroenterology consultant and from a consultant radiologist. We found that the investigations carried out by the board in response to Mrs C's symptoms had been appropriate, thorough and timely. Although one of the tests had not been fully completed, it had been reasonable not to repeat the test, as other appropriate tests had been arranged. The scans carried out by the board did not show any significant abnormalities. We considered that the actions of the board had been reasonable and that there was no clear evidence of any failings or undue delays. We did not uphold Mrs C's complaint.

Summary

Mr C complained about the treatment provided to him during attendances at West Glasgow Minor Injuries Unit, Yorkhill and then at the emergency department of Queen Elizabeth University Hospital. Mr C had sustained an injury to his right calf muscle and he said that it was only following a subsequent admission to the Queen Elizabeth University Hospital, a day after his initial admission there, that he was diagnosed and treated for pulmonary embolism (a blockage in a blood vessel in the lungs) and deep vein thrombosis (DVT).

We obtained independent advice from a consultant in emergency medicine who said that the symptoms Mr C presented with at West Glasgow Minor Injuries Unit, Yorkhill were consistent with him having sustained a calf muscle tear and not a venous thrombosis. They found that the treatment provided to Mr C was appropriate.

With regards to Mr C's attendance at Queen Elizabeth University Hospital, the adviser said that medical staff had rightly suspected that Mr C may have had a pulmonary embolism and he was offered appropriate tests in order to diagnose this. However, it was recorded in the medical records that Mr C had declined these tests and opted to go home because the tests involved the use of needles to which Mr C had a severe phobia. It was further recorded that Mr C was judged as having capacity to make this decision. We received further advice that when Mr C was admitted to the Queen Elizabeth University Hospital the following day there had been changes in his clinical condition. The adviser found no failings in Mr C's treatment.

We were satisfied we had not seen evidence that there were any unreasonable failures to provide Mr C with appropriate clinical treatment for his reported symptoms of leg pain and we did not uphold his complaint.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of Mrs A about the care Mrs A received at the Queen Elizabeth University Hospital. Specifically, she complained about a delay in a scan being carried out, the temperature of the room Mrs A was in and that Mrs A's food and fluid intake were not adequately monitored.

We took independent advice from a consultant physician and a nursing adviser. We found no clear reason why Mrs A had been on bed rest which would have placed her at risk of loss of muscle tone. However, this did not appear to have had a significant impact on her, nor did we consider there was any undue delay in scanning her knee. We did not identify evidence related to the room temperature being unreasonably cold. We acknowledged the board had taken steps to address the provision of food and concluded that Mrs A's fluid and nutrition intake were reasonably assessed and monitored during her admission. We did not uphold Ms C's complaints.

Summary

Ms C complained that the board unreasonably failed to diagnose and treat the cause of her back pain. She had suffered chronic back pain since being involved in a motorbike accident a number of years previously. Ms C said that she had not been provided with a satisfactory resolution and explanation for her ongoing pain and she felt that the care and treatment she had received had been inadequate. Ms C said her mobility had been affected, and she continued to require to take strong pain medication.

We obtained independent medical advice from a trauma and orthopaedic consultant and a consultant neurologist. The advice we received was that both the orthopaedic and neurology care and treatment provided to Ms C was consistent and appropriate. The advisers did not identify failings in Ms C's care and treatment. We did not uphold Ms C's complaint.

Summary

Ms C underwent an operation to her thumb. Over a year later it had still not healed despite two further attempts to revise the scar and after a review by a second opinion. Ms C complained that the clinician concerned with her treatment then refused to treat her further, saying that the cause of the failure to heal was self-harming. Ms C further complained a second clinician refused to provide surgery to her knee even though imagery showed that it was suffering from degeneration.

Ms C raised her concerns with the board who took the view, overall, that Ms C had been treated appropriately, in accordance with guidance, and that the conclusions and decisions about her thumb had been reasonable.

We took independent clinical advice and found that the clinician involved had done all they could with regard to Ms C's thumb in an effort to get it to heal. They had investigated the circumstances to establish the reasons why it had failed to heal and it was not unreasonable to conclude that the recurrent breakdown of the scar was self-inflicted. With regard to Ms C's knee problems, the board had followed current national guidance not to offer surgery in such cases. We therefore did not uphold Ms C's complaint.

Summary

Ms C complained about the care and treatment provided to her late mother (Mrs A) by the medical practice. In particular, she complained that the practice delayed taking action which diagnosed Mrs A was suffering from pancreatic cancer. We took independent GP advice and found that the practice had acted promptly in referring Mrs A for specialist intervention and that there were no delays in sending the referrals. The medical records detailed that Mrs A was referred to hospital twice under the two-week cancer pathway. We did not uphold the complaint.

Ms C also raised concerns that the practice had failed to investigate Mrs A's abnormal liver function results taken in 2014. The advice we received was that the test results had not shown any deterioration until September 2015 and at that time the practice had acted reasonably in making an urgent referral to hospital. In view of the advice that the practice's response was reasonable, we did not uphold the complaint.

Ms C was also concerned that the practice had failed to take appropriate action on Mrs A's reported weight loss. The clinical records demonstrated that Mrs A had been referred for dietary advice and attended a dietician clinic, and the advice we received was that the referral had been made at an early stage. We were satisfied, based on the medical records and independent advice we received, that the practice responded appropriately to Mrs A's reported weight loss and we did not uphold the complaint.

Finally, Ms C complained that the practice failed to ensure appropriate palliative care was put in place for Mrs A at home. The advice we received was that, based on the medical records, the practice had not delayed in referring Mrs A to palliative care services and that the practice offered reasonable care. We did not uphold the complaint.

Summary

Mr C complained that the SPS had inappropriately failed to pay him the correct wage. He said his wage had been cut from £13 to £7.

The information available confirmed that Mr C had been receiving a weekly wage of £13 for working full time in the kitchen. However, he then transferred to another prison. He was returned from that prison a few weeks later because of poor behaviour and he was assigned a part-time role in the kitchen and he received a payment of £7 per week. Mr C was also able to supplement his wage through attending education.

We were satisfied the Mr C was being paid appropriately by the SPS in line with their wage earning policy and we did not uphold the complaint.

Summary

Mr C complained that the Scottish Prison Service (SPS) had failed to follow relevant procedures to ensure his safety in a shared cell. In particular, he said that he should not have had to share a cell with a prisoner whom he alleged had attacked him. Mr C said that he had raised concerns about this prisoner but that no action was taken.

We were satisfied that, based on the available evidence, the SPS had followed the correct procedures prior to reaching their decision that Mr C was required to share a cell with another prisoner and that the situation was regularly assessed. We found no evidence that Mr C had raised concerns about the prisoner and did not uphold Mr C's complaint.