Not upheld, no recommendations

Summary
Ms C complained that the board failed to take adequate care of her jewellery when she was taken to theatre at Monklands Hospital. Ms C explained that she was prepared for surgery in the ward before being taken to theatre and a nurse taped a ring on her finger. She said that just outside theatre, nursing staff noticed that she was still wearing a necklace and medal and removed them as they were not allowed in theatre. Ms C said she never saw the items again.

During our investigation of the complaint, we reviewed copies of Ms C's medical records and her complaint file, including notes of the board's investigation of her complaint and interviews with the nursing staff involved. We also reviewed the board's internal procedure for dealing with enquiries/claims and their procedures on the handling of, or checks for, jewellery. In addition, we obtained a copy of the disclaimer notice displayed in the hospital wards and a copy of the in-patient booklet which contains advice on bringing valuables into hospital.

The documentary evidence showed that the board followed their normal procedure in this case. The documentation completed at the three separate stages for Ms C's admission to theatre clearly stated that she was only wearing her wedding ring. It was, therefore, not possible to prove that Ms C was wearing the additional jewellery at the time she went to theatre and that the board failed to take adequate care of her jewellery. We did not uphold the complaint.

Summary
At around six weeks old, Miss C's baby (Baby A) developed laboured breathing and was not sleeping or feeding well. She was referred to hospital by her GP who noted that was symptomatic of an upper respiratory tract infection (URTI). Baby A was triaged and seen by a junior doctor at Wishaw General Hospital. She was noted as having a four-week history of worsening wheezing, cough and intermittent fever. It was also noted that Miss C described Baby A as making a 'squeaking noise' when breathing.

The junior doctor diagnosed a URTI and this diagnosis was supported upon review by a paediatric registrar. Baby A was discharged home with arrangements put in place for follow-up review at home. Baby A was reviewed three days later. She was found to have a stridor (high-pitched breathing sound, normally associated with a blockage in the throat). Further examination by a consultant, and a chest x-ray, resulted in Baby A being transferred to Yorkhill Hospital, where she was diagnosed with a hemangioma (a benign tumour partially blocking her airway). Miss C complained that Baby A's condition had not changed during the time she was at the first hospital and that, therefore, the stridor had been missed and the hemangioma diagnosis delayed. She also complained about the attitude and actions of the junior doctor and the board's complaint handling.

Our investigation did not find that the hemangioma could have been diagnosed earlier. We found that the stridor would have been an indicator for the condition, but that none of the four medical staff who originally examined Baby A recorded this symptom, which is relatively simple to identify. We were satisfied that Baby A's symptoms were indicative of a URTI and established that the symptoms associated with hemangioma can be exacerbated by URTIs, indicating that her condition likely developed and worsened. We were unable to comment in specific detail on the actions of the junior doctor, but did not find any evidence that issues complained about had any impact on Baby A's treatment. We were also generally satisfied with the board's complaint handling.
 

Summary
Mr C complained about the care and treatment he received from his medical practice. Specifically, he said that he had been prescribed the wrong drugs for his illness. He maintained that he had resisted the prescriptions but that his GP had refused to change or stop his medication. He believed that his continuing mental health problems were as a consequence of receiving the wrong drugs.

The investigation found no evidence to suggest that the treatment given to Mr C was incorrect. We also did not find any evidence to suggest that Mr C had asked for his prescriptions to be changed or stopped or that his requests had been refused. We found that all the drugs prescribed to Mr C were appropriate for his presenting condition, and we did not uphold his complaint.

Summary
Mrs C complained on behalf of her family about their removal from a GP list. The family, a mother suffering from terminal cancer and two adult daughters, temporarily moved house and left the area after having been registered at the practice for a number of years. When the family returned to the town, but not to their former home, they applied to re-register at the practice.

Their application was refused because of a deteriorating relationship between Mrs C's daughters and the practice, which had been on-going for three to four years. Mrs C claimed that the family had been removed from the list without explanation and that when reasons were given they were inaccurate and inappropriate. She also complained that correspondence about the matter was not responded to.

Our investigation found that the family had been removed from the list when they removed themselves - albeit temporarily - from the geographical area covered by the practice. At this time, a collective decision was taken by the practice that should the family return to the area they would not be re-registered due to the breakdown of the relationship between the practice and Mrs C's daughters.

The family did move back into the area but not to their former home and there were other practices closer to their current address. Therefore, it was thought beneficial for the family to register with a GP closer to their home address due to Mrs C's cancer treatment. When Mrs C's daughters appealed to the practice for their mother alone to be re-registered this was refused, as it was not thought practicable.

Our investigation found that reasonable explanations had been provided to the family as to why they could not be re-registered and that the original removal for geographical reasons had been appropriate. It also found that correspondence on the matter had been responded to by the practice in a timely and reasonable manner. We, therefore, did not uphold the complaints.

Summary
Mrs C's late husband (Mr C) was a cancer sufferer. She complained that his practice failed to prescribe him antibiotics when blood test results suggested he had an infection and also that they failed to contact him when repeat blood tests were returned early and before he was scheduled to return to the practice. She also complained that the GP(s) failed to spot the seriousness of his condition.

Mrs C had to call an ambulance for her husband five days after his blood tests suggested an infection. He was taken to Ninewells Hospital where he died shortly afterwards of cardiac arrest and sepsis. Mrs C was told that her late husband's body had been overwhelmed by the infection and she felt that this caused or contributed to her husband's cardiac arrest.

We took advice from a medical adviser, who said that the actions of the GPs had been reasonable. He concluded that the GPs had taken full recognition of Mr C's condition and medical history. He also said that as the first blood test results were not conclusive, it had been appropriate to repeat them. The results from the second tests were also not conclusive and in some areas had actually improved. Our adviser took the view that it was, therefore, reasonable for the GPs to wait for the scheduled appointment to review Mr C. He also concluded that the infection which overwhelmed Mr C, although showing early but non-specific signs in the blood tests taken by the GPs, could not have been predicted from the results available to them at the time.

We did not uphold this complaint.

Summary
Miss C was diagnosed by hospital consultants as having fibromyalgia, neurological functional disorder and probable Crohn's disease. She complained that her GP did not accept these diagnoses and subsequently failed to provide treatment for them. In particular, she complained that her GP deleted a range of medications from her prescription list without good cause.

We found that Miss C's GP was not convinced by the diagnoses, but provided treatment in line with recommendations from various consultants. Medication was also withdrawn in line with specialist opinion. We did not consider it unreasonable for the GP to express his concern about the diagnoses to Miss C given that her treatment progressed appropriately.
 

Summary
Ms C complained about the care and treatment she received throughout her pregnancy and what she considered to be the mismanagement by the board of her labour and her baby's birth. She claimed that she had not been properly monitored; that matters were not properly explained to her and that she had not received appropriate treatment during her pregnancy and labour. She further complained that she was not properly monitored and cared for after the birth and she alleged that, as a consequence of this mismanagement, her daughter required medical treatment.

We investigated Mrs C's concerns, and obtained independent specialist advice. This established (and it was confirmed in the appropriate records) that the care and treatment Ms C received was satisfactory and that there were no issues of concern. In the circumstances, we made no recommendations in this case.

Summary
Mrs C complained to the board about the delay in diagnosing her son (Mr A) with asperger's syndrome when he was 41 years old. Mr A had been examined by various doctors since he was 8 years old and Mrs C wished to know why it had taken so long to reach a diagnosis.

We found that autism-spectrum disorders are a complex group of developmental disorders which are frequently associated with other psychiatric disorders which can colour their presentation and complicate their management. Asperger's syndrome was formally recognised by the World Health Organisation in 1992 and by the Diagnostic and Statistical Manual of Mental Disorders in 1994. Our medical adviser explained that due to system overlap, some people with asperger's syndrome can be wrongly diagnosed with other mental health disorders. However, it was possible that some of Mr A's previous diagnoses could have been legitimate mental health disorders in their own right. We found no evidence that there had been a delay in reaching Mr A's diagnosis of asperger's syndrome.
 

Summary
Mrs C visited her dentist to have a crown checked that had been causing her pain. After treatment, Mrs C complained that the dentist had extracted a perfectly healthy crown and had failed to give her any anaesthetic at the initial attempt to extract the crown. Mrs C said that after the dentist had pulled a couple of times at the crown, she shouted at him to stop as she felt sick and was shaking badly. The dentist then administered anaesthetic and both the crown and tooth were removed. Mrs C was dissatisfied that the dentist had not carried out an x-ray to see if the tooth was fractured or needed to come out.

In response to the complaint, the dentist said that Mrs C attended the practice complaining of a loose crown and when he attempted to remove it, she experienced quite a lot of pain and so local anaesthetic was given. The dentist documented that he suspected the crown may have fractured the root of the tooth and that extraction was probably required due to the resistance and mobility of the crown. The dentist also said that very little force was required indicating advanced gum disease and that this was supported by an x-ray taken in 2006 that had shown the root of the tooth to be particularly short with surrounding bone loss from periodontal disease.

Our dental adviser said that previous treatment had been carried out on the affected tooth which meant that the nerve and blood supply of the tooth had been removed. We found that it was, therefore, appropriate for the dentist to have attempted to remove the loose crown without giving any local anaesthetic as there was no longer any nerve supply to the tooth.
The adviser stated that the pain Mrs C had been experiencing in this tooth is often indicative of an underlying problem beneath the gum, such as an infection or a fractured root. He explained that the 2006 x-ray showed the presence of gum disease and a relatively short root indicating that a lesser amount of pressure would be required to remove the tooth.

He also said that, assuming the tooth was loose and given the x-ray, it is likely that the bone loss would have progressed in the intervening years and at some point the tooth would require extraction, although it was impossible to predict when this would happen. Therefore, we concluded that the treatment provided was appropriate.

Summary
There was significant flooding in Mr C’s area in July 2011. Mr C considered that, on a particular day that month, the cause of the flooding was a blockage in a Scottish Water sewer. He complained that Scottish Water had not maintained their sewer system adequately. He considered that Scottish Water should be required to proactively monitor the system by inspecting their entire network of pipe work to ensure blockages did not occur. He considered that that a failure to do so led to the flooding of his local sewer on that day in July 2011, because it was blocked.

We explained to Mr C that Scottish Water do not have any obligation to monitor their sewer network in the way he suggested. Therefore, we did not uphold the complaint. Nevertheless, we did consider what had caused the flooding in July. Our investigation revealed that there had been severe thunderstorms locally on the day in question, with torrential rain which caused extensive flooding in many parts of the area.

Scottish Water said that, following the flood, they had used CCTV cameras to check for any blockage but had only found the normal debris which is naturally and unavoidably present in many sewers. Although this debris was not causing a blockage, Scottish Water did clear the debris. All the evidence, therefore, pointed to the cause of the flooding as being the rain, rather than any blockage or anything that proactive monitoring could have prevented.