Not upheld, no recommendations

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.

Summary

Mrs C complained about the care and treatment her child (Child A) received from a practice managed by the health board. Child A had initially attended the practice for treatment of tonsillitis. However, they continued to be unwell and Mrs C took them back to the practice a number of times over the subsequent months.

Mrs C complained that, despite raising concerns about Child A's symptoms with the GPs, her suspicion that Child A may have glandular fever was not properly investigated. Based on Child A's presentation, the practice concluded that they were suffering from post-viral symptoms. However, Mrs C stated that this was never communicated to her. Mrs C complained that the practice did not provide reasonable care and treatment to Child A in respect of their presenting symptoms.

We took independent advice from a GP. We found that the clinical decision-making and management in respect of Child A's presenting symptoms was reasonable. From the review of the consultation notes, it was likely that post-viral symptoms were discussed with Mrs C. However, we concluded that it was not possible to categorically confirm this from the medical records kept by the practice. While we did not consider this to mean that the practice failed to provide reasonable care and treatment to Child A, we did provide feedback about the fact that Mrs C was not left with a clear understanding of the diagnosis that had been made. However, on the basis of reasonable care and treatment being provided to Child A, we did not uphold this complaint.

Summary

Mr C complained about the treatment which he had received at A&E of Caithness General Hospital. He had initially contacted NHS 24 and arrangements were made for him to be taken to hospital. Caithness Hospital does not have an ear, nose and throat (ENT) department and Mr C said that he expected to be transferred to another hospital to see the specialists there, but instead he was discharged home. Mr C's GP made a subsequent referral to ENT at Raigmore Hospital. Mr C felt it had inappropriately been downgraded and that he was not provided with appropriate treatment for his reported symptoms.

We took independent advice from an A&E consultant and from an ENT consultant. We found that Mr C had been appropriately assessed and treated at A&E on his initial attendance, and when he was subsequently referred to the ENT department, his symptoms were appropriately assessed and reasonable investigations were carried out in an effort to reach a diagnosis. We did not uphold the complaint.

Summary

C complained about their detention under an emergency detention order under the Mental Health (Care and Treatment) (Scotland) Act 2003. C stated that the detention was unnecessary and that the board failed to inform them about it. C also complained that there was a failure to offer support and signposting to advocacy services.

We took independent advice from a consultant psychiatrist (a medical practitioner who specialises in the diagnosis and treatment of mental illness). We found that the detention was appropriate from both a clinical and legal perspective under the Mental Health (Care and Treatment) (Scotland) Act 2003. We found that it was considered to be in C's best interests to detain them because of legitimate concerns about their mental health. The documentation was signed by a medical practitioner with full General Medical Council (GMC) registration and with the consent of a mental health officer, in accordance with the requirements of the act. We did not uphold this aspect of C's complaint.

We also found that C was informed of their detention within a reasonable period of time. We noted that prioritisation was given to addressing C's mental and physical health. The clinical team sought the views of C's relatives to inform their ongoing clinical management of C. Under the circumstances, this was an appropriate and reasonable action which then resulted in C's detention being revoked early. We did not uphold this aspect of the complaints.

Summary

C underwent a left total hip replacement for progressive osteoarthritis (chronic breakdown of cartilage in the joints leading to pain, stiffness and swelling). Following the surgery, it was identified C suffered nerve damage which resulted in a foot drop/sciatic nerve palsy (loss of movement and or lack of sensation) and a limp. C complained that the board failed to provide the appropriate aftercare to address these issues.

The board confirmed they provided the appropriate aftercare in the form of an ankle foot orthosis (a brace) and physiotherapy. The board noted C's initial problems had resolved and there were other factors that contributed to C's ongoing issues.

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 C's foot drop was managed appropriately by the provision of the orthosis and several physiotherapy sessions. We also concluded that the board's opinion that there were other factors which were the cause of C's ongoing problems was reasonable. We did not uphold the complaint.

Summary

Mrs C complained about the care and treatment provided to her late sister (Ms A) by practice. Ms A had attended the practice on a number of occasions over many months. She had symptoms of low energy and mood, fatigue, and lack of motivation. The practice diagnosed a depressive illness and prescribed antidepressant medication. Ms A continued to deteriorate and was admitted to hospital where it was found that she had had a tumour at the base of her skull and she later died. Mrs C said that the practice should have considered alternative diagnoses rather than depression.

We took independent advice from a GP. We found that it was reasonable for the practice to continue along the route of a depressive illness in view of Ms A's reported symptoms, and it was only when red flag symptoms were reported that it was appropriate to refer Ms A to hospital. Therefore, we did not uphold the complaint.