Not upheld, no recommendations

Summary

Mrs C complained about the care her late daughter (Miss C) received from her former GP practice between January and August 2011 after Miss C was diagnosed with a brain tumour in July 2012. Mrs C was concerned that Miss C was misdiagnosed with depression and, given that her symptoms (headaches, dizziness, tiredness and dilating pupils) were getting progressively worse, she should have been referred for a brain scan. Mrs C also provided evidence to show that Miss C had been unwell at college and had attended another medical facility.

We took independent advice from one of our medical advisers who is a GP. Based on their advice, we found that the initial diagnosis of vertigo was reasonable based on the symptoms of dizziness and abnormal eye movements. It was also noted that Miss C had described symptoms of anxiety which were explored by the practice, and the reasons for this were plausible. We did not find evidence in any of the records made of the eleven GP consultations, the records made by the college, or medical facility, that Miss C had reported suffering from headaches or that her condition was getting progressively worse. We found that Miss C's symptoms were not consistent with the symptoms of brain tumour set out in the relevant Scottish guidelines for referring patients for urgent assessment (such as for a brain scan). We concluded that this was a tragic case where Miss C's symptoms were not clearly typical of a brain tumour.

Summary

Mrs C complained about the pregnancy care she received from Raigmore Hospital. She said that the hospital failed to perform basic medical tests and that there was an inappropriate evaluation of her health which resulted in her pregnancy loss. Mrs C had a past history of thyroid problems and she complained that the management of this problem had been unreasonable. Mrs C also complained that no examination was carried out after her pregnancy loss to make sure everything was all right.

We took independent advice from a consultant obstetrician and gynaecologist. Our investigation found that overall the care and treatment given to Mrs C was reasonable, including the care and treatment Mrs C received when she attended the hospital with bleeding. The advice we received was that the hospital had also reasonably managed Mrs C's thyroid levels and there was no evidence that the loss of her pregnancy was caused by her thyroid condition or its treatment. We were also satisfied that, as Mrs C's pregnancy loss had occurred abroad, the hospital had not been aware of the situation until they contacted Mrs C when she missed a number of appointments. When responding to Mrs C's complaint, the board offered a further appointment to discuss what further investigations were appropriate at that time. In light of our findings, we did not uphold Mrs C’s complaint.

Summary

Mrs C had a hysterectomy (surgery to remove the womb) for a fibroid uterus at the Royal Alexandra Hospital. She said she then suffered an infection, was in severe pain, and had bladder problems. Mrs C was discharged home and later visited her GP who gave antibiotics for a urine infection. The following month, Mrs C attended a follow-up appointment at the hospital and was diagnosed with a vesico-vaginal fistula (an abnormal opening connecting the vagina to the urinary tract). She had to have further surgery to repair it. She was dissatisfied with her treatment and that a fistula had occurred, which had a very detrimental effect on many aspects of her life. Mrs C complained that the fact that she had suffered a vesico-vaginal fistula should have been discovered while she was an in-patient, and she should not have been discharged given her condition.

We took independent advice from a medical adviser. We found that the post-operative care and treatment provided was reasonable, as was the decision to discharge Mrs C, and that it was also reasonable to assume that the fistula developed as a later complication.

Summary

Mr C complained that the board failed to prescribe him specific medication for his drug addiction, and that his drug worker did not listen to his concerns.

We looked at Mr C’s medical records, and we took independent advice from one of our medical advisers. We found that the prison health centre kept detailed records of consultations with Mr C, and that they took his state of health into account when deciding not to prescribe him the specific medication he wanted. The records confirmed that assessments carried out by Mr C’s drug worker were appropriate. We concluded that the prison health centre’s actions were reasonable in the circumstances, and that the care provided by them was of a reasonable standard. We did not uphold Mr C’s complaint.

Summary

Miss C complained to the medical practice because she said the doctor had inappropriately told her mother (Mrs A) at a consultation that she had been diagnosed with dementia. Miss C said the doctor repeated the diagnosis of dementia to both herself and her father in further phone calls. However, it was confirmed that Mrs A did not have dementia. The doctor denied telling Mrs A and her family that she had been diagnosed with dementia. Instead, the doctor said she advised that there was a possible diagnosis.

Having reviewed the related medical information, the evidence available suggested dementia was being explored as a possible diagnosis and at no point was it confirmed as having been diagnosed. We did not see any evidence to suggest that the doctor, or any of the other clinicians involved in Mrs A's case, had confirmed a diagnosis of dementia. Therefore, we did not uphold the complaint.

Summary

Mrs C had been receiving medication prescribed by her medical practice for around ten years. However, the practice reviewed her medication and decided to stop it. Mrs C complained to us about the decision to stop her medication and the practice’s response to her complaint.

We looked at the practice’s complaints file and Mrs C’s medical records, as well as taking independent advice from one of our GP advisers. Relevant guidance stated that medical practices should review medication periodically. We found that the practice had done so, while also taking advice from appropriate specialists. In addition, the practice had offered Mrs C an alternative, which was to receive her medication on a private prescription.

Although the practice’s response to Mrs C’s complaint could have provided some additional information, it dealt with the key point of why they would no longer prescribe the medication to her, which we decided was reasonable in the circumstances. We did not uphold Mrs C’s complaints.

Summary

Ms C complained about the care she received when she attended A&E at Crosshouse Hospital. She also complained about the care she received from the out-of-hours service at Ayrshire Central Hospital. Ms C presented with abdominal pains and was diagnosed with a viral infection. She was prescribed painkillers and anti-sickness medication, and was then discharged. She was later diagnosed with acute appendicitis (inflammation of the appendix) and underwent surgery to have her appendix removed.

We sought independent advice from one of our advisers who specialises in emergency medicine, and one of our GP advisers. They both noted that appendicitis is difficult to diagnose as the symptoms it often presents with are similar to many other, more common, conditions. The views of the advisers were that, on both occasions, Ms C was examined thoroughly and given the correct advice and medication based on her symptoms at the time. Therefore, we did not uphold the complaint.

Summary

Mrs C complained about the standard of treatment her father (Mr A) received from the practice in the final months of his life. Mr A had been diagnosed with bladder cancer in 2012 and had received radiotherapy treatment for this. He remained under the care of a urologist (doctor who specialises in disorders of the urinary tract) and his cancer remained under control until January 2013. At that point, Mr A’s condition deteriorated, and he experienced weight loss and significant pain. At a follow-up urology appointment in August 2013, he was found to have developed untreatable cancer that had spread to his bones and spine. He was admitted to a hospice for palliative care (care provided solely to prevent or relieve suffering) shortly afterwards.

Mrs C complained that her father’s blood sugar levels were not adequately monitored, and that his pain was not managed effectively by the GPs at the practice between early 2013 and September 2013.

We obtained independent advice from one of our medical advisers. We accepted their view that the practice had managed Mr A’s pain in line with national guidance for the control of pain in adults with cancer. We acknowledged that Mr A had experienced significant pain which would have been distressing for him and his family. However, we recognised that pain management in cancer patients can be complex, and it is not always possible to achieve immediate or complete pain relief.

We were also satisfied that Mr A was referred for appropriate specialist investigation and that the practice referred him to the hospice appropriately.

Summary

Mr C complained that the Scottish Prison Service (SPS) did not transfer him to another prison nearer to his family, so they could visit him.

It was clear that Mr C was frustrated that his family could not visit, as they lived some distance away from his prison. However, we found that the SPS made reasonable efforts to transfer him nearer to his family over a period of time. Unfortunately, this was stalled for a number of valid reasons, including operational difficulties faced by Mr C's preferred prison. The SPS eventually managed to transfer Mr C to the prison nearest to his family. We did not uphold Mr C's complaint.

Summary

Mr and Mrs C complained to us that the council had failed to take reasonable action in response to their concerns about flooding at properties that belonged to their son and daughter. They said that the council had failed to meet their duties under the Flood Risk Management (Scotland) Act 2009.

The council had assessed the risk of flooding in the relevant area and had issued two options to property owners to resolve the matter. They considered that one of these would cost more than the other and told residents that if that option was chosen, they would require the properties benefitting from this work to come to an agreement to share the additional cost beyond the cost of the cheaper option. The residents failed to reach an agreement and, consequently, no work was carried out.

The council have discretion in relation to the Flood Risk Management (Scotland) Act 2009. Under our legislation, we can check that a council has followed the correct process. However, if the decision was made properly, we cannot question or change it. We found that the council had delayed in dealing with some of Mr and Mrs C's correspondence. Although we said that these delays were unacceptable, we were satisfied that the council had apologised to Mr and Mrs C for this and had taken steps to try to prevent problems of a similar nature occurring. The council had also tried to resolve the matter by presenting two options to residents and we found that this was reasonable. We considered that the council had acted reasonably in relation to their duties under the Flood Risk Management (Scotland) Act 2009 and we did not uphold the complaint.