Not upheld, no recommendations

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.

Summary

Mr C complained about the treatment provided to his late father (Mr A) when he was admitted to Biggart Hospital for a mental health assessment. While in hospital, Mr A's condition deteriorated and he stopped eating and drinking. His medication was amended but Mr A subsequently died of an infection. Mr C felt that Mr A's deterioration was due to the medication prescribed for his mental health problems. He also said that, despite repeatedly reporting his concerns to staff, they did not take his views into account.

The board said that Mr A had been prescribed appropriate medication for his mental health issues, that his medications were continually monitored, and that they were amended in view of the changes to Mr A's clinical condition. They also explained that there was evidence of regular communication with Mr C.

After taking independent advice from a medical adviser who is a consultant in old age psychiatry, we did not uphold Mr C's complaint. We found that the doctors involved in Mr A's care provided appropriate treatment for his physical and mental health symptoms. The medications prescribed were appropriate, and were closely monitored and amended when required. We also found that the staff were fully aware of Mr C's concerns about his father's treatment, and that they took these concerns into account when setting up the treatment plan.

Summary

Mr C said that the board failed to follow Scottish Government procedures on NHS continuing healthcare which resulted in his father (Mr A) not being assessed for continuing healthcare when he should have been. Mr C said that if an assessment had been carried out, Mr A would have had care provided by the NHS and would not have had to pay around £45,000 for residential care in a private nursing home.

We took independent advice from one of our medical advisers, who specialises in care of the elderly. We found that Mr A did not meet the criteria for continuing care. Having said that, the process was not as clear as it should have been to Mr C. The board accepted that the decision about whether or not to provide NHS continuing care should be fully explained to the family at the time of an assessment. The board took this issue forward with healthcare staff. Given that the guidance has been superseded and the process changed since June 2015, and that the communication issue had been taken forward by the board, we made no recommendations.