Not upheld, no recommendations

Summary

Mr C complained about the care and treatment he received at University Hospital Monklands in relation to hip pain. In particular, Mr C was concerned that the board mismanaged his condition and did not identify that he required a hip replacement following scans and x-rays.

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 the care and treatment provided to Mr C was reasonable. We noted that, based on the findings of the x-rays and the scan, there was no indication that Mr C should have been offered surgery at that time. We did not uphold Mr C's complaint.

Summary

C complained to the board about their discharge from hospital. The discharge letter to C's GP said that C would be followed up by a consultant psychiatrist in an out-patient clinic and by C's community psychiatric nurse (CPN). C attended the consultant psychiatrist's out-patient clinic. Based on their assessment of C on that day, the consultant psychiatrist discharged C from the clinic. Later, C became concerned about a related matter. When pursuing this further, C spoke to their GP who told C that they had been discharged from the consultant psychiatrist's clinic. C complained to the board that they had not been advised of being discharged. The board told C that the consultant psychiatrist recalled that the discharging had been discussed. C disputed this and also complained that a promised referral for CPN follow-up had not taken place. The board reiterated their response regarding the discharge and explained that a referral to a CPN was not felt to be required following an occupational therapy assessment in the days following their discharge from hospital. The board apologised that this had not been communicated to C appropriately. C was dissatisfied and raised their complaints with this office.

We took independent advice from a suitably qualified adviser. We concluded that the failure to action the promised referral for CPN follow-up had been reasonable in the circumstances and that the available evidence indicates that C was advised that they would be discharged by the consultant psychiatrist. We did not uphold C's complaint.

Summary

C complained about the ophthalmology (eye) care and treatment provided by the board when they had surgery for cataracts (when the lens, a small transparent disc inside the eye, develops cloudy patches). There had been a complication during the procedure which meant that C had to undergo further surgery at a later date. C was concerned that the procedure was not carried out appropriately and that the follow-up was not reasonable.

We took independent advice from an ophthalmologist. We found that all aspects of care, from the decision to carry out cataract surgery and do this under local anaesthetic, to the management and follow-up of the complication, was appropriate. We therefore did not uphold C's complaint.

Summary

C complained on behalf of A, who has a history of complex congenital heart disease (a problem with the structure of the heart). A was admitted to Hairmyres Hospital, treated for paroxysmal atrial fibrillation (a heart condition that causes an irregular and often abnormally fast heart rate) and a possible chest infection, and discharged a few days later. A was readmitted to hospital three weeks later and diagnosed with endocarditis (an infection of the heart valves). A said that they had asked a doctor specifically about endocarditis during the first admission, but the doctor told them they had been tested for endocarditis and did not have it. C complained that A should have had blood cultures (a test used to detect bacteria or fungi in a person's blood) taken to test for endocarditis during this first admission.

The board did not uphold C's complaint. They said that doctors considered whether A had endocarditis, but ruled this out because A did not have symptoms of endocarditis at the time. The doctor said they told A that tests showed they did not have a significant underlying infection, but not that they had been tested specifically for endocarditis.

We took independent medical advice from an appropriately qualified adviser. We found that endocarditis was considered, but it was reasonable for doctors to rule this out based on the evidence at the time. We also found that it was reasonable for doctors not to take blood cultures during this admission, based on A's symptoms. The medical records stated A was told that they did not have a 'significant infection' (rather than endocarditis specifically), and we did not consider A was given incorrect information about being tested specifically for endocarditis. We did not uphold this complaint.

Summary

Mrs C, an MSP, complained on behalf of her constituent (Ms A). The complaint related to the care and treatment provided by the board to Ms A's late partner (Mr B) who died by suicide.

Mrs C complained that the board had failed to provide appropriate care and treatment in respect of Mr B's mental health. We took independent advice from a consultant psychiatrist. We found that the care and treatment the board provided was reasonable and appropriate. We acknowledged that we could not know for certain what was discussed between clinicians and Mr B or Ms A. However, we concluded that the records made by different clinicians were consistent with each other and the board provided appropriate care and treatment to Mr B, based on the information known at the time. The board had acknowledged some failings in respect of providing information about self-referral to addiction services. However, we considered that this related to communication rather than care and treatment. As such, we did not uphold this complaint.

Mrs C's second complaint was that Mr B's medical records repeatedly state he was using cannabis in the days before his death. However, the post-mortem and toxicology report indicated that there were no drugs in his system when he died. Mrs C complained that the board had not provided a satisfactory explanation for this. The board said that they could not establish why the post-mortem and toxicology report did not find drugs in Mr B's system or explain the apparent contradiction between this and the medical records. We were not able to confirm exactly what was discussed during the consultations before Mr B's death. However, given the consistency of the medical records, it was reasonable to conclude that the understanding of the clinical staff who reviewed Mr B was that he was using cannabis on an ongoing basis at that time. Therefore, we did not uphold this complaint.

Mrs C also complained that the board's out-of-hours service failed to respond to Ms A's request to provide medication for Mr B in a reasonable or appropriate manner. Ms A stated she was told that urgent medication to calm Mr B down could not be issued and that she felt her concerns were dismissed. We took independent advice from a GP. We found that the care and treatment provided by the out-of-hours service was reasonable and appropriate. We found that the decision not to provide or prescribe medication was appropriate and in line with relevant guidance. The out-of-hours service appropriately arranged an appointment with the Community Mental Health Team and advised Mr B to attend the emergency department if necessary. We did not uphold this complaint.

Finally, Mrs C complained about how the board handled Ms A's complaint and the standard of their communication during the complaint process and related reviews. In particular, Mrs C highlighted what they considered to be miscommunication over the scope and process of the review, delays in the board issuing their stage two complaint response, and questioned the investigating officers impartiality.

We found that it was appropriate for the board to carry out a Suicide Review before issuing a stage two complaint response. Although it took longer than the standard 20 working day timescale for the board to provide a stage two response, we did not consider their handling of the complaint to be unreasonable. We did not consider there to be any evidence that the investigating officer failed to investigate the complaint impartially. We also noted that comments provided by other senior staff during the course of the complaint investigation were reflected accurately in the stage two response. We considered the handling of the complaint to be reasonable and did not uphold this complaint. However, we acknowledged there was some confusion caused by the board referring to both a Significant Adverse Event Review and a Suicide Review and fed this back to them.

Summary

C's parent-in-law (A) suffered from symptoms that they later learned were caused by having a stroke, and was taken by emergency ambulance to University Hospital Monklands. A CT scan carried out that day was reported as normal, but A's condition continued to deteriorate and they were admitted to the intensive care unit and put on life support. The following day, a repeat CT scan was performed which showed evidence of A having had a severe stroke and, following discussions with family, their life support was switched off and they died. C was concerned about the time it took staff to diagnose A with a stroke.

We took independent advice from a medical adviser. We found that the management of A including investigations and treatment decisions were appropriate and carried out within a reasonable time. Clinicians considered the possibility that A had a stroke and took appropriate action by arranging a CT scan, and then a further CT scan the following day. We did not uphold the complaint.

Summary

Mrs C complained about the care and treatment of her late son (Mr A). Mr A had a history of mental health and addiction problems. Mrs C complained about the role of the board's addictions service in Mr A's treatment. Mrs C said that Mr A was prescribed drugs that had a damaging effect on his mental state. She considered that the drugs should not have been prescribed in combination, and without appropriate supervision. She raised concerns that she was unable to support Mr A as she was excluded from discussions about his care. While it was on record that Mr A did not wish for information about his care to be shared with his mother, Mrs C did not consider that Mr A had capacity to make that decision. In any event she considered that the clinicians' duty of care and Mr A's right to life should have overridden any obligations to protect his right to confidentiality.

We took independent medical advice from a consultant psychiatrist. We found that the drugs prescribed to Mr A are commonly prescribed alongside one another and were appropriate for the treatment of his problems. We considered that there was appropriate monitoring of Mr A's clinical state, and that it was appropriate for clinicians to act in line with Mr A's expressed wish for information not to be shared with Mrs C. We noted that the assessment of Mr A's capacity appeared reasonable and that Mr A's recorded clinical presentation was reasonably not viewed as meeting exceptional circumstances that would have permitted breaching his confidentiality.

We did not uphold the complaint.

Summary

Mrs C complained about the care and treatment of her late son (Mr A). Mrs C complained that Mr A was prescribed drugs that had a damaging effect on his mental state. She considered that the drugs should not have been prescribed in combination, and without appropriate supervision. She raised concerns that she was unable to support Mr A as she was excluded from discussions about his care. It was on record that Mr A did not wish for information about his care to be shared with Mrs C. Mrs C did not consider that Mr A had capacity to make that decision, and felt that the clinicians' duty of care and Mr A's right to life should have overridden any obligations to protect his right to confidentiality.

We took independent medical advice from a GP and a consultant psychiatrist. We found that the drugs prescribed to Mr A are commonly prescribed alongside one another and were an appropriate treatment option. We considered that the monitoring of Mr A's clinical state was reasonable, and that it was appropriate for clinicians to act in line with Mr A's expressed wish for information not to be shared with Mrs C. We found that the assessment of Mr A's capacity appeared reasonable and that Mr A's recorded clinical presentation was not viewed as meeting exceptional circumstances that would have permitted breaching confidentiality.

We did not uphold the complaint.

Summary

Mrs C complained to us on behalf of her late son (Mr A). Mr A was admitted to University Hospital Monklands for surgery to treat perianal abscesses (a collection of pus or infected fluid near the anus). Mr A was discharged home and received visits from district nurses to check his surgical wounds. Mr A began to feel unwell and he died a few days after his discharge home.

Mrs C complained that Mr A did not receive reasonable care and treatment in the hospital and that district nurses failed to recognise Mr A was seriously unwell.

We took independent advice from a colorectal surgeon (a surgeon who specialises in conditions in the colon, rectum or anus) and a nurse. We found that the care and treatment Mr A received in the hospital was reasonable and there was no indication Mr A should not be discharged home. We found no evidence that district nurses were aware that Mr A was feeling unwell. Therefore, we did not uphold the complaint.

Summary

Mrs C complained about the treatment which she received at A&E of Raigmore Hospital following a fall where she bumped her head and suffered hearing problems. The staff believed the hearing loss would be temporary and discharged her home. However, Mrs C's hearing loss continued over a number of months and she attended her GP on a number of occasions. A referral was made to the ear, nose and throat department (ENT) where a hearing aid was fitted. Mrs C believed that she should have been referred to ENT specialists at the time of the A&E attendance.

We took independent advice from a consultant in emergency medicine. We found that staff at A&E carried out appropriate investigations at the time of Mrs C's attendance and that it was reasonable to suspect the hearing loss would be temporary. There was no clinical indication for an immediate referral to ENT and advice was given to attend her GP should the symptoms not resolve. We did not uphold the complaint.