Not upheld, no recommendations

Summary

Mrs C complained that the board had neither diagnosed nor treated her eye condition reasonably. She also felt they had not given her sufficient information about medication she was prescribed previously (Mrs C felt she should have been made aware of the possible visual side effect, as her medication was ultimately thought to have contributed to her subsequent eye condition). She was also unhappy with the board's response to her complaint.

Mrs C's complaint made it clear how strongly she felt about this matter and how much her condition had affected her. Although we recognised that and took it into account, our role was to consider whether the board's steps were reasonable in the circumstances at the time. We took independent medical advice from three advisers – a GP, an ophthalmologist (a doctor who examines, diagnoses and treats diseases and injuries in and around the eye) and a rheumatologist. They all thought that medical staff had, overall, taken reasonable steps to diagnose and treat Mrs C's condition. This included the steps taken at her medical practice and also at Raigmore Hospital.

In terms of Mrs C's historic medication, our medical advice was that the side effect she highlighted and appeared to have suffered was very rare and, in addition, it was associated with a pre-existing medical condition Mrs C had. The evidence indicated that she was given the standard information leaflet at the time she was prescribed her medication. Although we recognised that this leaflet may not have been as detailed as Mrs C may have liked, we did not consider this meant that clinical staff had acted unreasonably. In terms of the board's response to Mrs C's complaint, we had to consider whether any inaccuracies, viewed as a whole and within context, were enough to make it unreasonable. Our medical advice was clear that Mrs C had suffered from a rare and complicated condition and this was reflected in the detailed correspondence. Although we recognised that any discrepancies would be frustrating we felt, on the whole, that the board reasonably sought to address Mrs C's queries. We did not uphold this complaint.

Summary

Ms C complained about the standard of nursing care provided to her mother (Mrs A) during an admission to Glasgow Royal Infirmary. Ms C felt her mother had been over-sedated with morphine when she was not in pain; was denied food; and that staff had labelled Ms C as being abusive towards them. The board felt that Mrs A received appropriate nursing care but were aware that Ms C found the situation difficult.

We took independent advice from one of our nursing advisers. Our adviser was satisfied with the level of nursing care provided in relation to the morphine and nutrition issues. It was also recorded that the staff found Ms C to be distressed. We did not uphold the complaint as the nursing care was appropriate and was in line with what the board had explained. However, we acknowledged that Ms C had found the situation distressing.

Summary

Mrs C had some metal work removed from her hip at the Southern General Hospital with the aid of an epidural anaesthetic. Afterwards, she said that she had not properly regained feeling in her right leg and that she had problems urinating. She said that she had been discharged from hospital too soon and that reasonable investigations had not been made into her symptoms.

She complained to the board but they were of the view that her discharge had been appropriate and that all reasonable investigations had been undertaken into her continuing problems. Mrs C was unhappy and complained to us.

We took independent advice from a consultant trauma and orthopaedic surgeon. We found that on the day of her discharge, Mrs C had been reviewed by a physiotherapist and assessed as safe to go home; her condition was improving and no further interventions were planned by medical staff. Thereafter, Mrs C's complaints about her leg and urination were extensively investigated with scans, nerve conduction studies, blood tests and a lumbar puncture being carried out. She had reported that her condition was improving. In the circumstances, we did not uphold Mrs C's complaint.

Summary

Mrs C complained that when she was admitted to the Western Infirmary with increasing shortness of breath and a productive cough (a cough that produces mucus and phlegm), she was assessed by a clinical nurse specialist (CNS) who said that she could be discharged home that day under the Early Supported Discharge (ESD) service. Mrs C had concerns that she was not fit for discharge and she remained in hospital until she was further assessed by a doctor as being fit for discharge. Mrs C was transferred to Gartnavel General Hospital prior to her discharge home. Mrs C complained that the CNS should not have assessed her as being fit for discharge and that when she arrived at Gartnavel Hospital her portable oxygen cylinder was found to be not working. She said that it must not have been checked at the Western Infirmary.

We took independent advice from our nursing adviser and found that the CNS was an appropriate health professional who was qualified to assess Mrs C and that her decision that Mrs C was fit for discharge, further to medical review, was appropriate. We made no finding on the complaint as to whether the oxygen cylinder was working on discharge from the Western Infirmary as there was no substantive evidence to establish when the oxygen cylinder stopped working. This may have occurred at the time Mrs C was being taken from the Western General or in transit during the hospital transfer.

Summary

Mr C complained to us that staff had failed to carry out an MRI scan (a scan used to diagnose health conditions that affect organs, tissue and bone) when he attended Glasgow Royal Infirmary after injuring his back at work. Although a junior doctor who examined Mr C had recorded that an x-ray and MRI scan should be considered, Mr C was then reviewed by a consultant orthopaedic surgeon, who decided that they were not required. Mr C continued to suffer from back problems and considered that he would have received treatment for this earlier if an MRI scan had been carried out on the day he injured his back.

We took independent advice on Mr C's complaint from a medical adviser who is an experienced consultant in trauma and orthopaedic surgery, with a specialist interest in lumbar spine problems. We found that an MRI should be carried out on patients where surgery is being considered because of escalating pain and/or neurological deficit or those in whom the pain has persisted for several weeks (this is usually a minimum of six weeks with no improvement). We found that it was reasonable that an MRI scan was not carried out when Mr C attended hospital on the day he injured his back. It was also appropriate not to carry out an x-ray at that time. We therefore did not uphold Mr C's complaint.

Summary

Mr C, who is an advice worker, complained to the board about the care and treatment Ms A received from Stobhill Hospital in relation to the fitting of a mirena coil (a contraceptive device inserted into the womb which can treat heavy bleeding). Six years later, there were difficulties in removing the device. It was found to be embedded in her womb and had to be removed under general anaesthetic. Ms A believed that she may not have been suitable for a mirena coil because of having a retroverted (backward-tilting) womb. She felt that this should have been taken into account before the device was implanted, and was concerned about not being properly informed of the risks.

We took independent advice from one of our medical advisers who is a consultant gynaecologist. We found that there were no clear records of a verbal discussion taking place with Ms A about the possible risks associated with the procedure. However, there were clear records showing that the doctor had given her a patient advice leaflet, which provided enough information for Ms A to make an informed decision. We also found that, before fitting the coil, the doctor had carried out a pelvic examination to check the positioning of Ms A's womb. This was in accordance with national guidelines and done to ensure that the mirena coil was appropriately positioned. It can be difficult to clearly identify the positioning of a woman's womb, and although it was likely in retrospect that the womb was retroverted, we did not consider this an unreasonable failing at the time.

Summary

Mrs C complained to us about the Glasgow Dental Hospital's decision to give her son (Mr A) colchicine (a medication normally used to treat gout) to treat his mouth ulcers. Mr A had mental health problems and subsequently died from an overdose of the medication. Mrs C said that the medication was not listed as a treatment for mouth ulcers. She also considered that the doctor who had recommended the prescription of the medication had failed to adequately assess the risks of giving this to Mr A, in view of his mental health problems and previous suicide attempts by overdosing.

We took independent advice on Mrs C's complaint from an adviser who is a consultant in oral medicine. We found that colchicine is an appropriate choice of drug for mouth ulcers. It had been reasonable to give this to Mr A because the ulcers extended into his throat and other treatments had not been successful. The doctor had been aware of Mr A's mental health problems and of his suicide attempts by overdosing. The doctor considered that the risks of this happening again were mitigated as Mr A received his medication on a daily basis to reduce the chance of overdosing. We considered that, based on the evidence available at the time, it had been reasonable for the doctor to decide that Mr A should be given colchicine. We did not uphold the complaint.

Summary

Mrs C, who is an advocacy worker, complained on behalf of her client (Mrs A). She said that Mrs A had complex medical conditions and that she began to suffer from seizures after the practice had prescribed indapamide (medication for high blood pressure). The practice said that Mrs A's blood pressure had risen due to her other medication and that they prescribed indapamide in order to control her blood pressure. They said they monitored her condition and also sought medical advice from a hospital specialist.

We took independent advice from one of our GP advisers. Our adviser was satisfied that the practice had prescribed the medication appropriately, and that they had sought specialist advice and monitored the situation. We did not uphold the complaint.

Summary

Mr C complained about the care and treatment provided to his wife (Mrs C) by her GP practice in relation to her stomach problems. The practice investigated her stomach problems by carrying out blood tests and arranging for further investigations in hospital. When she was admitted to hospital, it was subsequently established that she had a mass on her liver, and it was confirmed that she had secondary cancer of the liver. Mr C complained of a lack of treatment and investigations into Mrs C's symptoms by the practice, and said that if they had taken her abdominal problems more seriously, then the cancer would have been diagnosed sooner.

We took independent advice from one of our medical advisers, who specialises in general practice. We found that the practice properly investigated Mrs C's symptoms, including making referrals to secondary care within a reasonable time, and that, overall, the treatment provided was reasonable.

Summary

Mrs C complained about the way the medical practice handled two phone calls when she became ill while on holiday. During the first call, which was made by her son, Mrs C felt that the receptionist concentrated too much on the fact that she was currently outside the practice area and that she should seek an appointment with a local GP practice. Mrs C did so and the GP diagnosed quinsy on her tonsil (a complication of tonsillitis where an abscess forms between a tonsil and the throat). Mrs C phoned the practice the following day to arrange an appointment for when she returned home. She was informed that there were no pre-bookable appointments available for the next two days. Mrs C felt that the reception staff should have sought advice from a doctor rather than make decisions about whether her medical condition could wait until an appointment was available.

We sought independent clinical advice from a GP adviser who felt that the practice had handled both calls appropriately. During the first call, her son was advised that Mrs C should seek a medical opinion from a local GP in order that her condition could be assessed. During the second call we found that the receptionist had accurately explained the process for making appointments. We did not uphold the complaint.