Not upheld, no recommendations

Summary

Ms C, who is an advice worker, complained to us on behalf of Ms B about the care and treatment of her late father (Mr A) during an out-of-hours GP visit. This visit came shortly after Mr A had been diagnosed with lung cancer.

Ms B said that her father had become increasingly short of breath and was looking very unwell. The family called NHS 24 and requested a home visit. Mr A spoke to a nurse on the phone, and was assessed as needing a home visit within an hour. Ms B asked that the GP not mention the new cancer diagnosis to her father, as he was not fully aware of it. About half an hour after the call, a GP arrived. She assessed Mr A's condition, and listened to his chest. She noted his vital signs, and as not all her equipment was working fully, she judged his temperature by touch and found that he did not have a fever. Following discussion with the family, Mr A was not transferred to hospital, but was given medication for his cough and to reduce pain. Shortly after the GP left, Mr A collapsed and had to be resuscitated by his family until an ambulance came. He was taken to hospital, where he died the following afternoon.

We took independent advice from one of our medical advisers, who based their findings on the notes made by the GP at the time. We noted, however, that the accounts given by the GP and Ms B in relation to what happened during the visit were somewhat different. Our adviser said that during the consultation the GP took appropriate action in relation to her assessment of Mr A's condition. She had taken account of Mr A's medical history, and took the family's views into consideration in suggesting that he remain at home and be reviewed by his GP the following morning. However, the adviser was slightly critical of the level of detail in the GP's notes.

In coming to a decision on this complaint, we were not able to determine what exactly happened during the consultation, given the conflicting accounts. However, based on the clinical records made at the time, the advice we were given indicated that the GP assessed Mr A's condition appropriately, and appropriately considered the family's wishes when planning treatment.

Summary

Ms C complained that doctors at the practice did not recognise multiple chemical sensitivity (MCS) as a medical condition and had refused to supply her with a doctor’s note for a housing application she had made. Ms C said that the practice only provided consulting rooms which were heavily perfumed through the use of air fresheners, and that they had focused unreasonably on her illness being psychological.

During our investigation we took independent advice on Ms C's complaint from one of our medical advisers. We found that MCS is not a recognised medical condition, so the doctors were not able to certify Ms C as suffering from it. We found no evidence that the rooms at the practice were over-perfumed or that the use of air fresheners by the practice was targeted at Ms C. Given that MCS is not a recognised medical condition and in view of the symptoms she was displaying, we found that the doctors had acted responsibly in suggesting that Ms C might benefit from accessing mental health services.

Summary

Mr C was referred to the board's neurosurgical unit after an angiogram (a type of x-ray used to examine blood vessels) showed that he had two cerebral aneurysms (weak points in the walls of blood vessels supplying blood to the brain, causing them to bulge or balloon out). The referral was passed to a consultant neurosurgeon for consideration. Five days later, it was returned to the waiting list team, then passed to another consultant neurosurgeon the same day, for Mr C to be placed on a waiting list initiative list, so that he would be seen sooner.

Mr C, however, collapsed about a week later. He was admitted to hospital and a scan of his head was taken. This showed evidence of subarachnoid haemorrhage (bleeding in the area between the brain and the thin tissues that cover the brain). He was taken to theatre for emergency surgery, but this was abandoned due to the continuing bleeding and swelling in his brain. Mr C was then transferred to the intensive care unit, where he died later that day.

Mr C's wife complained about the care and treatment he received from the board before his death. After taking independent advice from one of our medical advisers, we found that it was reasonable for them to at that point put Mr C on the waiting list initiative list, which meant that he would have been seen sooner. The adviser explained that there was no indication from the medical records that Mr C had displayed any symptoms of subarachnoid haemorrhage at that time. We also found that Mr C had received reasonable care and treatment in hospital on the day he died.

Summary

Mr C, who is a prisoner, complained about the care and treatment provided to him by the prison doctor. The prison doctor had diagnosed Mr C as having external piles (small lumps that develop on the outside edge of the anus), but Mr C disagreed with this diagnosis.

We took independent advice on this complaint from one of our medical advisers, who considered Mr C's medical records. The adviser told us that the symptoms reported by Mr C did indicate that he had external piles and because of that, the prison doctor's diagnosis and treatment were reasonable and appropriate.

Summary

Mrs C said that her husband (Mr C) first attended his medical practice in January 2012 complaining of breathlessness and low mood but that it was not until November 2012 that it was confirmed that he had lung cancer. Mr C died in December 2012 and Mrs C complained that the practice had unreasonably delayed in providing a diagnosis.

To investigate the complaint, we considered all the relevant documentation, including the complaints correspondence and Mr C's medical records, as well as obtaining independent advice from one of our medical advisers. We found that, throughout, the practice had acted reasonably and no areas of delay were identified. Our adviser said that Mr C had an extensive and significant medical history, some of which could have explained the symptoms he was experiencing. He explained that there were many causes for breathlessness and no set guidelines on how to investigate it. He said that, given Mr C's history and the fact that his examinations had been normal, the practice's approach was reasonable. He did note that, on occasion, it appeared that there was a long wait for hospital appointments, but this was not the fault of the practice, who tried to move them forward. The adviser also explained that it was regarded as good practice to approach diagnosis sequentially, particularly when the patient was not deteriorating, and said that the practice could have done little more to obtain an earlier diagnosis for Mr C.

Summary

Miss C had root canal treatment on one of her front teeth in 2012. After the treatment, she experienced pain and swelling which did not improve with antibiotics that were prescribed by her dentist. Whilst on holiday, she visited another dentist (the second dentist) who removed the root canal filling and found that she had two perforations in the tooth. He provided a temporary filling so that Miss C could discuss further treatment with her own dentist when she got home. Miss C was later referred for specialist dental surgery so that she did not have to lose the tooth. She complained that her dentist did not carry out the root canal treatment to a reasonable standard and did not provide her with a reasonable level of aftercare.

We found that the tooth had first been root canal treated in 2006, but that this work was not completed. In 2012 Miss C's dentist had removed the original root canal filling and re-filled the tooth. We took independent advice from our dental adviser, who said that Miss C's tooth was filled well and that x-rays taken after the treatment showed no sign of any perforations. The perforations were, however, visible on an x-ray taken by the second dentist, who had used a softer filling material to diagnose the problem. Our adviser explained that the perforations could have been caused either when the first dentist removed the original filling, or when the second dentist removed the first dentist’s filling. Although the infection that Miss C developed was suggestive of a perforation after the first dentist’s treatment, there was no evidence of this on the x-ray. We concluded that there was insufficient evidence to say that Miss C's dentist had caused the perforations. Furthermore, we were satisfied that he took all reasonable measures to establish whether the procedure had been successful, and that he provided appropriate medication and onward referral to a specialist when Miss C had problems following her treatment.

Summary

Mr C was unhappy with the decision of a university faculty appeal committee (the FAC) not to uphold his appeal against a decision to transfer him from a PhD (doctor of philosophy) study path to a Masters course. Mr C appealed the FAC decision and submitted evidence of personal difficulties to be heard by the senate appeals committee (the SAC). He appealed on the grounds that he had new information and documentary evidence to support his view that the FAC was not given enough background information on issues raised by a supervisor. Mr C also considered that that the documentary evidence sometimes contradicted written information submitted by a supervisor. The university decided that there were no grounds for an SAC hearing and ruled that the FAC's decision stood.

Mr C complained to us that the university did not follow their appeals policy when they considered whether the senate appeal should be heard, as he said they did not accept the new documentary evidence he submitted or his statement that his supervisor's written response to the FAC was an inadequate representation of events. We did not, however, uphold his complaint. After we carefully considered all the relevant policies related to Mr C's complaint alongside all the points of his complaint, we found that the university had correctly followed their policies and procedures with the FAC appeal and had correctly followed their policies in not holding a SAC hearing.

Summary

Mrs C complained that Scottish Water had failed to consult the public about planned work to the water supply in her area and that since this reduction in the water pressure, equipment in her house and her central heating boiler were not working properly. She said that it was unreasonable for Scottish Water to reduce the pressure, rather than repairing or replacing pipes and upgrading the mains for which they were responsible.

Our investigation found no evidence that Scottish Water had a requirement to consult their customers about this work. It had been undertaken in stages, and Scottish Water told us that the majority of their customers in the area would not have noticed any change. We did consider whether it would be appropriate to ask Scottish Water to consider consulting in future but they told us that a problem had been reported in only a handful of cases, and that they had followed these up and either taken action or provided advice to the customer where it was a matter for them to resolve.

We found that Scottish Water had chosen to reduce the pressure because they considered that there were a number of benefits from this. We found nothing to suggest that there was anything wrong with their decision-making in this respect. In Mrs C's case, she had been provided with additional support, and as Scottish Water had found that the problems she was experiencing were related to water flow rather than pressure, they had installed new pipe work from the main pipe to the boundary of her property, and had reimbursed her for the costs of engaging a plumber to fix an issue with her sanitary ware.

Summary

Mr C is the solicitor of a prisoner with a disability (Mr A). Mr C complained that the prison would not arrange for members of staff to assist Mr A in moving round the prison. The prison said arrangements were in place for another prisoner to do so, but Mr A did not feel safe with this and believed that the prison were failing in their duty of care towards him.

The prison informed us that the arrangements in place involved Mr A being assisted by another prisoner who had undertaken appropriate training. They advised that this task would be carried out in the presence of a prison officer. They confirmed that the prison rules allow the governor to require a prisoner to work in the service of another prisoner. They, therefore, concluded that a prisoner could be tasked with this, provided that their suitability had been assessed and health and safety and training issues considered.

We did not uphold the complaint, as we were satisfied that the prison were entitled to have a suitable and appropriately trained prisoner carry out the task of assisting Mr A. We noted that, in terms of Mr A's concerns for his safety, a member of staff would always be present when this task was being carried out. We noted Mr A's dissatisfaction with the arrangements, but did not consider that this, in itself, provided evidence of maladministration or service failure.

Summary

Mr C, who is a prisoner, complained that he had been unable to attend a course which he needed to do before being considered for parole in a few months' time. We did not uphold his complaint, as we knew from other complaints that there was a long waiting list for the course in question. We were satisfied that the prison were acting in accordance with prison policy in calculating Mr C's position on the waiting list and in not having been able to guarantee a place in time for his parole hearing.