Not upheld, no recommendations

Summary

C complained on behalf of their client (B) in relation to the care and treatment provided to B’s spouse (A) whilst A was a patient within the board. A had a complex medical history and was referred to Queen Elizabeth University Hospital, receiving care and treatment over two days. B’s specific concerns related to a procedure A underwent on the second day. On that day, CT scan findings showed the presence of a large liver abscess which was possibly the result of a perforated gallbladder. Treatment options were reviewed and the best option was considered to be draining the abscess percutaneously (by accessing the abscess through the skin rather than operating and opening the abdomen). A passed away that day.

C told us that B believed that the procedure was not the best clinical option for A and that A would not have died had the procedure not been undertaken. B felt that A’s judgement was impaired because of medication which they had been prescribed, and as such was not competent at the time of making the decision to have the procedure, so could not agree to it.

We took independent advice from a surgical adviser. We found that the care A received during their admission was reasonable and followed accepted management pathways. We noted that the board assessed and provided the best clinical option of treatment. We found no evidence to suggest that A was impaired by the medication prescribed to them and as such was competent to consent to the procedure. We did not uphold C's complaint.

Summary

C complained that the board failed properly to investigate the causes of their neck and shoulder pain. As a result, they said that they experienced up to 20 migraines a month and spent a large part of time in bed. C said that they regularly asked for an x-ray but were told that it would not be appropriate and were prescribed a number of medications and botox, none of which had effect. Because they were struggling with their quality of life, C attended a private chiropractor (a person who treats diseases by pressing a person's joints, especially those in the back) who took x-rays which revealed that the vertebrae at the top of their spine were out of alignment. The chiropractor then carried out a procedure to address this, as a consequence of which, C said, their migraines largely disappeared.

C believed that the board ignored their concerns about neck and shoulder pain and said that had they been addressed when requested, they would have had a better quality of life.

The board’s view was that, throughout, C had been treated appropriately and in line with clinical guidance; x-rays were not normally recommended in migraine diagnosis and management and were not standard practice. They also said that clinicians were not trained in alternative procedures and were unable to recommend them.

We took independent clinical advice. We found that x-rays were not part of the normal practice in the diagnosis and management of migraine and that neck and shoulder pain can occur in 90% of patients with migraine. We also found that the alternative procedure given to C was not an approach offered by the NHS and that C had been treated in line with clinical best practice. We did not uphold the complaint.

Summary

Mrs C complained about the care and treatment provided to her late husband (Mr A). Mr A was admitted to hospital after he attended A&E complaining of abdominal pain with a background of hiatus hernia (where part of the stomach pushes up into the lower chest). Mr A had a nasogastric tube (where a tube is placed through the nose into the stomach) inserted to decompress the hiatus hernia, however on one occasion it fell out and a number attempts had to be made before it was reinserted. During this procedure, Mr A suffered a cardiac arrest and died.

Mrs C complained that the board inappropriately handled the insertion of his nasogastric tube and raised concerns that it may have caused Mr A's cardiac arrest. Mrs C also complained that insufficient attempts were made to resuscitate Mr A when he suffered cardiac arrest.

The board explained that nursing staff escalated the procedure for passing the nasogastric tube appropriately and that Mr A arrested before any further escalation could happen. The board also explained that Mr A’s cardiac rhythm was asystole (unshockable) therefore attempts to prolong resuscitation would be ineffective.

We took independent advice from a consultant general surgeon and from a consultant in acute medicine. We found that reasonable action was taken by the nursing staff in escalating the reinsertion of the nasogastric tube and there was no evidence that the procedure was inappropriately handled. We also found that the decision to stop resuscitation was made in consultation with the clinical staff present and the decision was reasonable in light of his additional conditions and the fact that his heart rhythm was asystole. Therefore, we did not uphold Mrs C's complaints.

Summary

C complained about the treatment which they received at the Golden Jubilee National Hospital. C had undergone a total right hip joint replacement but post operatively reported problems with right foot drop and loss of sensation in the right foot and leg. C was put on medication and referred to physiotherapy but still remained in pain with loss of sensation. C felt that something must have gone wrong during the surgery.

We took independent advice from a consultant orthopaedic surgeon (a specialist in the treatment of diseases and injuries of the musculoskeletal system). We found that there was no indication from the clinical records that complications had been encountered during C’s surgery in that the surgery was completed within normal timescales and that blood loss was within expected levels. It was possible that the sciatic nerve (nerve in the lower back area) could have been inadvertently damaged during the surgical procedure but there was no documentation to support such a view.

While we did not uphold the complaint, we noted concerns about the standard of the record-keeping regarding the brevity of the actual operation notes and whether sufficient discussions about C’s high body mass index (BMI, a measure for estimating human body fat) level, which would increase risks of any surgery, were discussed with them prior to surgery. The concerns were highlighted as feedback to the hospital who have already amended their procedures in an effort to improve learning.

Summary

C’s sibling (A) attended the practice with constipation and blood in their urine. C was referred to the local health board’s urology department (specialists in the male and female urinary tract, and the male reproductive organs) where they were diagnosed with pedunculated fibroids (benign (non-cancerous) growths in the uterus). This diagnosis was later found to be inaccurate and the growths were found to be cancerous. C complained that the practice failed to provide reasonable treatment to A when they attended the practice in response to their symptoms.

We took independent advice from a GP. We considered that the actions and investigations carried out by the practice were reasonable at each appointment, based on the information available at the time. A was referred to appropriate specialities and prescribed reasonable medication in response to their symptoms and the diagnosis made by urology. We did not uphold the complaint.

Summary

C complained to the practice about their failure to diagnose that they were at risk of suffering a heart attack when they attended the practice on two occasions. The GPs had diagnosed a chest infection; however, C’s condition deteriorated and they were admitted to hospital where it was discovered they had suffered a heart attack. C felt that the GPs should have diagnosed their heart condition sooner and that if they had then their heart would not have been so damaged.

We took independent advice from a GP. We found that the GPs involved in C’s care carried out appropriate assessments and that the symptoms which C presented with were not indicative of cardiac problems. We did not uphold the complaint.

Summary

C was admitted to Stratheden Hospital following an overdose. C’s complaint is in relation to the care and treatment provided during this admission. C said they were left without medication and discharged without a proper follow-up plan.

The board acknowledged that medications were not available when they should have been. They said this was because C’s prescriptions needed to be ordered from the pharmacy and were not stocked on the ward. They said that a senior charge nurse had reminded staff to review prescriptions to ensure they are ordered in time. The board said they provided C with appropriate information about support services.

We took independent advice from a consultant psychiatrist. We noted that it was accepted that there was a delay with providing C with their medication. However, we found that the overall management of C’s condition was reasonable, with effective communication between staff and C documented throughout. As such, we did not uphold this complaint.

Summary

C was enrolled on a programme at the University of Edinburgh. C complained about the university's response to reports of bullying during their placements. We found that the university took reasonable action to address C's concerns regarding the difficulties they experienced on placement, in line with the relevant university procedures. We did not find evidence that the university failed to follow their own procedures regarding the reports made by C.

C complained that the university unreasonably denied them the opportunity to re-sit a small number of placements. We did not find any evidence of maladministration and procedural failings which would lead us to question the merits of the decisions taken by the university.

C also complained that the university did not reasonably respond to their appeals. We did not find any evidence of maladministration or a procedural failing which would lead us to question the merits of the decisions taken by university in relation to C's appeals. We did not uphold C's complaints.

Summary

C complained on behalf of their adult child (A), who has complex care needs and lives with C, about the care and treatment A received from the partnership.

C said that the partnership failed to carry out a reasonable support needs assessment for A and that they failed to prepare an appropriate outcome-based support plan.

We took independent advice from a social worker. We found that the action taken by the partnership in preparing the support needs assessment and outcome-based support plan was reasonable, and it was in line with relevant guidance and policies. We did not uphold the complaint.

Summary

C complained about the care and treatment provided to their child (A) by the board when A had various ear, nose and throat symptoms. A was admitted to Ninewells Hospital following a number of visits to their GP, and received treatment with steroids, antibiotics and oxygen. A was discharged after two nights with a plan for a follow-up sleep study. C complained that the board had not provided A with appropriate oxygen treatment, and that it was unreasonable for them to be discharged.

We took independent advice from a consultant paediatrician (a medical practitioner specialising in children and their diseases). We found that, overall, the care and treatment provided to A was reasonable, and that there was appropriate monitoring, documentation, and escalation of care. We considered the oxygen treatment and discharging A to be reasonable. We, therefore, did not uphold C's complaint.