Not upheld, no recommendations

Summary

Mr C contacted the housing association regarding the behaviour of his neighbour, who was their tenant. He said that a number of incidents had caused him and his wife to become stressed and upset. A few months later, he raised a formal complaint with the association expressing his unhappiness at what he considered to be their lack of action. However, the association replied to the effect that they were actively seeking an anti-social behaviour order against the neighbour but that the legal process involved was a lengthy one.

Mr C said that he wanted the tenant evicted but that the association had so far failed to take reasonable action.

We found that the association had responded promptly to Mr C's concerns about his neighbour and that legal proceedings were underway.

Taking the association's actions into account, we found that they acted reasonably in the circumstances and that the length of time taken for the legal proceedings to progress is outwith the association's control. We therefore did not uphold Mr C's complaint.

Summary

Mr C complained to us that when he took his son (child A) to the emergency out-of-hours service, he was not satisfied with the treatment given for child A's swollen eye and temple by the attending GP. The GP diagnosed child A was suffering from a chest infection.

Child A subsequently underwent neurosurgery to remove an abscess (a swollen area within the body tissue, containing an accumulation of pus) from the eye socket and was admitted for over six weeks.

We took independent GP advice and concluded that the GP had provided a reasonable level of care. The GP had noted a history of upper respiratory symptoms for two days (suggestive of viral/cold symptoms) and that both parents had similar symptoms. The GP examined child A's chest, breathing rate and temperature. The GP found that child A was likely to have a chest infection. Child A was given treatment and the family was told to return should they have further concerns. We found that this was a reasonable management plan.

The adviser noted that swollen/puffy eyelids can be common in children with viral illness due to them rubbing their eyes. If there was no evidence of a pus collection, then it was reasonable for the GP to adopt a 'watch and wait' management plan. We found that as the symptoms described could be consistent with a viral illness, it was not unreasonable that the GP did not diagnose the abscess during the visit. We therefore did not uphold Mr C's complaint.

Summary

Mr C complained to us about a delay in the medical practice referring him for a scan. The scan showed a diagnosis of testicular cancer. He had attended the practice on three occasions and it was only on the last attendance that he was referred for the scan. Mr C believed that the scan should have been arranged at either the first or second consultation.

We took independent GP advice. At the first consultation there was a report of a tender right testicle which had been present for two to three days. There was no lump and antibiotic medication was provided with a review the following week if the condition did not settle. A diagnosis of orchitis (inflammation of one or both testicles) was made. Mr C then reattended the practice some 12 weeks later with a report of right testicular discomfort again and repeat medication was provided. Mr C then attended again after a further five weeks and reported right testicular discomfort and a lump. The ultrasound referral was then made, in line with national guidance, which led to the diagnosis of testicular cancer.

We found that the practice had provided a reasonable level of care and that the referral was made at an appropriate time in view of Mr C's reported symptoms. We therefore did not uphold Mr C's complaint.

Summary

Mrs C complained about the standard of treatment provided to her father (Mr A) in relation to dead tissue in his big toe. Mr A was diabetic and suffered from a condition which affected his circulation. Mr A had several admissions to hospital and out-patient treatment, but after several months his condition deteriorated and he was admitted to Hairmyers Hospital with severe disease of the arteries.

A surgeon decided to manage Mr A's condition conservatively (without surgery), but Mrs C said that it was clear he was deteriorating due to an infection. After a week, another surgeon undertook an emergency operation to amputate Mr A's leg above the knee.

Mrs C complained that the board failed to ensure surgery was undertaken within a reasonable time and that this had an adverse effect on the outcome.

We took independent medical advice from a specialist in diagnosing and treating conditions which affect circulation. We found that the standard of care and treatment provided to Mr A was reasonable, that it was appropriate to initially treat Mr A's condition conservatively and that the time taken to perform surgery was reasonable. We also found no evidence that any other intervention would have saved Mr A's leg. We therefore did not uphold Mrs C's complaint.

Summary

Mrs C complained to us that at numerous consultations over a nine-month period, the medical practice failed to provide her with appropriate treatment for her reported pain in her right arm. By the time she was referred for a specialist hospital opinion, a diagnosis of non-Hodgkin lymphoma (a cancer that develops in the lymphatic system) was made. Mrs C believed that the GPs at the practice should have referred her to hospital earlier and that as a result she has had to undergo courses of chemotherapy and radiotherapy.

We obtained independent GP advice. We found that during the relevant period, in addition to the consultations at the practice, Mrs C attended the pain clinic and referrals to other departments. She also underwent an MRI scan and x-rays were taken. The symptoms which Mrs C reported to the practice were not in keeping with a diagnosis of non-Hodgkin lymphoma.

We found that the practice arranged appropriate referrals and also closely monitored Mrs C's pain relief whilst communicating frequently with the pain clinic specialists. We therefore did not uphold Mrs C's complaint.

Summary

Mr C complained that when he underwent a scan to establish whether there was evidence of gallbladder disease, a finding of atelectasis (collapse of small airway) was noted on the report. However, the finding was not brought to Mr C's attention or that of his GP and Mr C wondered whether the atelectasis required attention or was the cause of his health problems.

The board explained that the finding was not related to the purpose of the referral for the scan. They said that it was an incidental finding related to Mr C's respiratory problems, which were already being treated by the respiratory department.

We took independent clinical advice. We noted that the atelectasis was a finding of no consequence and would not normally require further action. We therefore did not uphold Mr C's complaint.

Summary

Mr C was admitted to Glasgow Royal Infirmary with acute left leg ischaemia (inadequate blood supply). Mr C later self-discharged. Arrangements were made for him to be seen a few weeks later for review and he was prescribed medication.

Mr C attended the vascular clinic on three more occasions and his condition began to improve. He was treated conservatively (non-surgically). On his condition being noted as stable, the plan was to continue to treat Mr C without surgery and to review him again.

However, Mr C said that he remained in severe pain and was disabled. His GP obtained a second opinion for him from a different health board and Mr C was later given vascular surgery. Mr C complained that the board failed to provide him with reasonable treatment.

We took independent advice from a consultant vascular surgeon. We found that Mr C's conservative treatment was in accordance with clinical guidelines and that his symptoms had been treated appropriately. While the threshold for surgery could vary between clinicians, that Mr C had not been given surgery at an earlier date did not represent substandard or unreasonable care. We therefore did not uphold this aspect of Mr C's complaint.

Mr C also complained about the way the board investigated his complaint. However, we found that he was provided with a timely and reasonable response and therefore did not uphold this complaint.

Summary

Mr C complained to us that the medical practice had failed to provide appropriate care and treatment to his late teenage daughter (Miss A). He said that Miss A had a lump on the side of her head which, over a couple of years, the doctors had said was a cyst. This turned out to be cancer.

Mr C felt that there had been a delay in reaching the diagnosis and that it was inappropriate that the practice had sent letters directly to his daughter about possibly removing the cyst at an earlier time. He said that he and his wife were not aware of the letters.

The practice responded that the presumption was that Miss A had a cyst, and that the option of removal under local anaesthetic was discussed. Miss A was given the opportunity to consider the excision along with the offer of a second opinion. When the cyst was noted to be increasing in size, Miss A was referred to hospital and cancer was diagnosed.

The practice explained that the diagnosis was unusual for a child of Miss A's age but that their investigation had identified a number of learning points.

We took independent GP advice. We found that based on the recorded evidence, there were no concerns about the way the GPs managed the situation. Initially there were no signs that the lump was sinister and the offer to have it removed was made. Miss A was competent to make the decision whether to have the lump removed at an earlier stage for cosmetic reasons rather than for clinical reasons and she decided not to have it removed. That was a reasonable decision for her and her parents to consider as her parents were involved in Miss A attending the practice at times. It was also reasonable for the practice to write directly to Miss A directly. We did not uphold Mr C's complaint.

Summary

Mr C complained to the board about various aspects of the care and treatment which was provided to his son (Mr A) at the Victoria Hospital. Mr A saw his GP, who sent him to hospital with a diagnosis of viral meningitis. Mr A was discharged after clinicians at the hospital made a diagnosis of a viral infection. He was admitted to intensive care the following day and was diagnosed with meningitis. Mr A died a short time later.

Mr C felt that the clinicians should have acted on the GP's diagnosis and that a lumbar puncture (a medical procedure where a needle is inserted into the lower part of the spine) should have been carried out.

We took independent advice from a consultant in emergency medicine. We concluded that although the GP had made a provisional diagnosis of viral meningitis, the staff involved took full note of Mr A's symptoms, carried out appropriate observations and investigations, and arrived at a reasonable diagnosis before discharging Mr A. Initially some of Mr A's results were abnormal but they improved over the time he was in A&E. We also found that there was no clinical indication to admit Mr A to hospital or carry out further investigations. We therefore did not uphold Mr C's complaint.

Summary

On attending his dentist, Mr C was noted to have dental decay in two of his teeth. It was agreed that this would be removed and his teeth would be filled. Despite this, Mr C remained in pain and he required root canal treatment. The treatment and known risks of such treatment were explained. Mr C experienced one of these risks in that a file broke during treatment and was required to be left in his root canal. Mr C's treatment was completed but he remained in pain.

Mr C complained that he did not receive appropriate or reasonable treatment. We took independent dentistry advice. We found that while it was regrettable that the instrument broke, this was not indicative of poor treatment and was a known risk, as was the possibility of continuing pain. We therefore did not uphold Mr C's complaint.