Not upheld, no recommendations

Summary

Ms C's partner (Mr A) collapsed. He was treated by a paramedic and transported to hospital, where he later died. Ms C complained that Mr A's mobile phone went missing.

Our investigation focused on the actions taken by the Scottish Ambulance Service to locate the phone or to try to find out what happened to it. Although they did not find the phone, we were satisfied that reasonable efforts were made to investigate this matter.

Summary

Mr C complained that the medical practice unreasonably failed to offer his son (Mr A) a referral for varicose vein surgery. Mr C was concerned that this was affecting Mr A's mental health. He was of the view that the practice were refusing to refer him for surgery because of Mr A's mental health problems.

We took independent clinical advice. We found that the practice had carried out a proper examination of Mr A and had noted that his varicose vein was not causing him discomfort. As a result of this, the practice were correct in following the board's guidance on the treatment of varicose veins which said that in instances such as this, varicose veins should be treated conservatively and surgical referrals should not be made. As a result, we did not uphold Mr C's complaint.

Summary

Miss C attended her dentist and reported mild discomfort in an upper tooth. Following an examination including x-rays, Miss C was advised that she required either extraction or root canal treatment of the tooth. Miss C chose to proceed with the root canal treatment which was carried out a few weeks later. Afterwards, Miss C experienced pain and swelling that resulted in her attending at the local out-of-hours service, where she received antibiotics for an abscess. Miss C returned to the dentist and was unhappy with the follow-up service.

After taking independent dental advice we did not uphold Miss C's complaint. We found no failings in the care and treatment that Miss C was provided with. The advice we received was that the treatment provided was appropriate and that the risk of the abscess had been covered in the risks and benefits information provided to her.

Summary

Mr C attended his medical practice with a persistent cough. He was referred for a chest x-ray and breathing tests. His x-ray was clear but he was unable to complete the breathing tests. Mr C's symptoms worsened so he made a further appointment and was prescribed an inhaler. His symptoms further worsened so he made another appointment and was prescribed a different inhaler.

Mr C began to experience hoarseness and a feeling of blockage in his throat. He made an appointment with a different GP, who requested blood tests and x-rays and made an ear, nose and throat (ENT) referral. A biopsy confirmed Mr C had throat cancer. Mr C complained that the initial GP had failed to provide him with appropriate treatment in view of his presenting symptoms.

We sought independent medical advice. They found that the care provided by the practice was of a reasonable standard and was in line with national guidelines. We accepted the adviser's view and did not uphold Mr C's complaint.

Summary

Miss C complained about the care and treatment that her partner (Mr A) received at Hairmyres Hospital. Mr A experienced a range of different symptoms and was seen by doctors from various specialisms as a result. He also attended at the A&E department on a number of occasions. Miss C and Mr A were concerned that no diagnosis was reached for Mr A's symptoms and a complaint was made to the board. Miss C was dissatisfied with the response.

After taking advice from a consultant physician and a consultant in emergency care, we did not uphold Miss C's complaint about diagnosis. The advice we received was that the board had carried out all appropriate investigations in the period covered by the complaint and that no physical cause for Mr A's symptoms had been identified.

We also did not uphold the complaint about the board's response to the concerns raised. We found that while this was brief, it addressed the issues raised.

Summary

Mrs C complained that a dental hygienist carried out a scale and polish procedure inappropriately and that this caused extensive damage to her teeth. We took independent dental advice. We found that there was no evidence to suggest the hygienist failed to carry out the procedure appropriately, or that this had caused damage to Mrs C's teeth. We did not uphold this complaint.

Mrs C also complained that the subsequent treatment and advice she received from a dentist was unreasonable. We were advised that the records indicated that appropriate treatment was provided and correct advice offered. We did not uphold this complaint.

In addition, Mrs C complained about the board's response to her complaint. She felt that they unreasonably disregarded the evidence of the further treatment that she received, which she considered supported her concerns that the scale and polish procedure damaged her teeth. She was also unhappy with the dentist's indication that they offered fluoride treatment for sensitivity when she said it was offered to address the damage to her teeth. We were advised that the further treatment Mrs C required was due to her teeth being worn and not as a result of any unreasonable prior treatment. We were also advised that fluoride treatment is usually offered to treat sensitivity or decay, and not damage to teeth such as that described by Mrs C. We therefore concluded that the board's response was reasonable and we did not uphold this complaint.

Summary

Ms C complained about the care her mother (Mrs A) received from her medical practice.

Mrs A had been experiencing diarrhoea for a number of weeks. The practice had prescribed medication, requested a stool sample and offered referral for a colonoscopy (imaging of the bowel). Mrs A later died in hospital.

We sought independent medical advice. The adviser was satisfied the practice had provided a reasonable standard of care. We therefore did not uphold Ms C's complaint.

Summary

Mrs C complained to us about the care and treatment that her mother (Mrs A) had received from her medical practice before her death. Mrs C considered that Mrs A should have been admitted to hospital earlier and that her death could have been prevented.

We took independent advice from a GP adviser. We found that the examinations carried out by the GPs and the treatment plan put in place for Mrs A had been reasonable. A urine infection had been treated appropriately with antibiotics and it had been reasonable to delay a blood test until she finished the antibiotics. The clinical entries in her records were of a reasonable standard and were in line with guidance from the General Medical Council.

We also found that on the final occasion Mrs A was seen by the GPs, the treatment given to her in relation to her chest symptoms had been reasonable and in line with the relevant guidance. However, her condition deteriorated later that day. She was admitted to hospital and died on the following day. There was no evidence that Mrs A's death was caused by or hastened by the GPs' actions or that it could have been prevented. When Mrs A saw the GPs, there had been no indication that she should be admitted to hospital.

We found that the care and treatment provided to Mrs A had been of a reasonable standard and we did not uphold Mrs C's complaint.

Summary

Mr C complained about the medical practice after they removed his family from the practice list for being outwith the practice boundary. Following a home visit to Mr C's father-in-law, the practice had advised that they felt the distance they had to travel presented a potential safety risk. This had led them to audit the practice list and they had decided to remove all patients outwith their boundary.

Mr C advised that, although his family was outwith the practice boundary, they had been registered there for many years following a complaint against their previous practice. He considered that this meant they should be allowed to remain on the practice list.

We found that the practice had clearly explained the reasons for their decision and given reasonable notice of the removal of services. We sought independent advice from a GP adviser, who was satisfied that the practice had complied with the provisions set out in the General Medical Services Contract for the removal of patients from the practice list, and that it was within their discretion to remove patients who were outwith their practice boundary. We accepted this advice and did not uphold Mr C's complaint.

Summary

Mr C complained about the care and treatment provided to him at Grampian Royal Infirmary following his diagnosis of prostate cancer. Mr C said that he had not been provided with all the information necessary for him to give informed consent for the prostate surgery he had undergone. Mr C said that the board had failed to provide him with a test result which showed that the indicator used to measure the cancer's activity had declined.

The board said that Mr C had been managed and advised appropriately. They accepted that he had not been provided with the test result, but said this was not required for him to have given his informed consent. Additionally the board noted that Mr C had had a number of detailed discussions with his clinicians about his treatment options.

We took independent medical advice on the treatment provided to Mr C. The adviser said that Mr C's management and treatment were in line with the appropriate clinical guidelines. It noted that Mr C had delayed his treatment as he had wished to travel abroad during it. During this trip, a test of his cancer indicators had shown a marked rise. The advice noted that the test Mr C was not informed about showed a lower level of this indicator. The medical decision to operate on Mr C was based on the assessment of a scan of his prostate, and a subsequent examination of the cancer showed it to be more serious than previously thought. The advice said this supported the decisions made by medical staff.

We found that the test level was not the determining factor in deciding whether Mr C should have undergone surgery. We found that for informed consent, Mr C needed to be provided with sufficient information to understand the reason for his surgery, the risks and benefits of the proposed treatment and the alternatives available to him. The evidence showed that this had been done and that the treatment Mr C was provided with was the appropriate one. We did not uphold Mr C's complaint.