Not upheld, no recommendations

Summary

C's adult child (A) lived in sheltered accommodation managed by the partnership. A had an overnight carer in their flat for a number of years. Technology Enabled Care (TEC) was later installed in A's flat to provide overnight care.

C complained that the partnership made unreasonable changes to A's overnight care provision. We took independent advice from a social work adviser. We found that the actions taken by the partnership were reasonable. Prior to the change being made the partnership considered C's concerns and responded to them, considered the information available to assess A's overnight needs, undertook appropriate risk assessments to identify risks and took steps to mitigate them where possible. A trial of TEC was undertaken, and at the point where TEC was to become the source of overnight monitoring it was phased in. The partnership also offered a review of the overnight care if A's behaviour changed. Therefore, we did not uphold this complaint.

Summary

Ms C complained to us about the practice after she was diagnosed with secondary breast cancer in her lymph nodes. She had been attending the practice with a number of separate symptoms including a drooping right eye, fatigue; pain in her right shoulder, a rasping voice, vomiting and fainting. She did not consider that these symptoms were ever properly considered as a whole, which may have prompted an earlier diagnosis. She was also concerned that there was a failure to appropriately ready her for the diagnosis, claiming she had been repeatedly reassured her symptoms did not point towards a serious diagnosis.

We took independent advice from a GP. We found that the symptoms were relatively common and were not suggestive of a cancer diagnosis. Given this, we considered that the practice's communication with Ms C had been reasonable. We did not uphold either of Ms C's complaints.

Summary

C arrived at Ninewells Hospital's emergency department by ambulance. After an initial assessment C was transferred to a mental health unit. C complained about the treatment provided at both locations. We took independent psychiatric advice.

We found that the treatment provided at Ninewells Hospital was reasonable, C was appropriately assessed and managed, with an appropriate referral to psychiatric services and appropriate steps taken to maintain C's safety. We did not uphold this aspect of the complaint.

We found the treatment provided at the mental health unit was also reasonable. A thorough examination of C was undertaken and during C's admission adequate monitoring and care of C was provided. We did not uphold this complaint.

Summary

Mr C, who had a previous history of repeated sinus infections, attended the day surgery unit at St John's Hospital for planned septoplasty surgery (corrective nose surgery). He was prepared for surgery by a nurse but Mr C was then reviewed by a doctor who decided that surgery was not required at that time and that Mr C could be discharged home with nasal capsules and would be reviewed at a later date. Mr C said that it was unreasonable that the doctor had overruled a previous consultant, who deemed that surgery was required, and that he was prescribed capsules which had not been effective in the past.

We took independent advice from an ear, nose and throat surgeon. We found that it is not unusual for planned surgery to be cancelled on the day of surgery. Clinicians who may have not seen the patient previously routinely review the symptoms reported and may determine that the surgery is cancelled or that alternative surgery should proceed instead. We did not uphold Mr C's complaint.

Summary

Miss C attended the Royal Infirmary of Edinburgh A&E having cut her lower right leg. The wound was treated with wound closure strips and a dry dressing. Miss C complained that it was not appropriate to treat her wound with strips and that they should have been sutured as she developed an infection and required further treatment. The board explained that wounds on the lower leg take longer to heal, are more prone to infection and it is unlikely suturing would have resulted in a different outcome.

We took independent advice from a medical adviser. We found that the use of wound closure strips can be as effective as sutures in cuts. There was no evidence to suggest that the treatment provided was unreasonable and it would not be possible to determine whether the wound would not have become infected if it had been stitched. Therefore, we did not uphold the complaint.

Summary

Mrs C complained that the reporting of x-rays taken of her knees was unreasonable. Mrs C was referred by her GP for an x-ray as she had been suffering from pain in her knees for over a year and her GP thought that she might be experiencing the onset of arthritis (a disease causing painful inflammation and stiffness of the joints) . Knee x-rays were carried out and Mrs C's GP later advised her that the x-rays showed no signs of arthritis. However, Mrs C subsequently attended a private hospital and was advised that x-rays did show early onset arthritis and swelling in both knees. Mrs C stated that the x-rays from the board had not been looked at properly.

We took independent advice from a consultant radiologist (a specialist in diagnosing and treating disease and injury through the use of medical imaging techniques such as x-rays and other scans). We found no evidence that the reporting of Mrs C's knee x-rays had not been reasonable but the images taken allowed for different interpretations and did not give a clear enough picture to result in a definite arthritis diagnosis. Therefore, we did not uphold the complaint.

Summary

C complained about the care and treatment they received from the practice. C had a history of back pain and attended a consultation at the practice. During the consultation, the GP discussed a number of pain relief medications with C and a prescription was made.

Approximately three weeks later, C presented to a hospital and received emergency treatment for cauda equina syndrome (a rare and serious neurological condition that affects the bundle of nerves (cauda equina) at the base of the spine). C raised concern that the practice missed signs of cauda equina syndrome when they attended the practice a number of weeks earlier. They were also unhappy with the treatment provided at the time.

We received independent advice from an appropriately qualified adviser. We found that an appropriate assessment was performed during the GP consultation. Having considered the accounts of C and the practice, we concluded that the practice did not miss red flags for cauda equina syndrome. We also considered that the discussion regarding medication and prescription were reasonable. We did not uphold C's complaint.

Summary

C complained on behalf of their sibling (A) who is a Type 1 diabetic. A was admitted to hospital twice following hypoglycaemic (low blood sugar) episodes. The second admission took place via A&E. The discharge letter for A's second admission described A as being 'anorexic' (an eating disorder where individuals feel a need to keep their weight as low as possible) and having 'learning difficulties'. A, and A's family, complained about the decisions taken to discharge A, about the treatment A received at A&E, that the board did not perform tests or investigate A's condition during A's second admission and about the descriptions of A included in the discharge letter.

We took independent advice from an appropriately qualified adviser. We found that that the decisions to discharge A had been reasonable, that A had been provided reasonable treatment within A&E, that A's management during the second admission had been reasonable and that the board's inclusion of the descriptions A took issue with in the second discharge letter were reasonable. We did not uphold the complaints.

Summary

Ms C had cataract surgery (a procedure that involves replacing a cloudy eye lens with a clear artificial one) at Hairmyres Hospital. Ms C stopped using the eye drops she had been prescribed and she began to have a feeling of discomfort in her eye. Ms C visited her optician who said there seemed to be a scratch on its surface. Ms C complained that something went wrong during her cataract surgery.

We took independent advice from an ophthalmologist (a specialist in eye disorders). We found that Ms C's cataract surgery was technically successful. We considered it was most likely that Ms C had suffered a small accidental scratch to the lens of her eye during the cataract surgery, which is a recognised complication. However, we found that there were no failings in how her cataract surgery was carried out. We also found that Ms C was given appropriate treatment for the discomfort she experienced. We did not uphold Ms C's complaint.

Summary

Mr C complained about the care and treatment his mother (Mrs A) received at University Hospital Monklands during her initial admission and subsequent readmission to hospital for treatment for supraglottis with parapharyngeal oedema (infections of the upper airways/throat).

We took independent advice from an ear, nose and throat consultant and from a consultant radiologist (a doctor who specialises in diagnosing and treating disease and injury through the use of medical imaging techniques) with experience in interventional procedures (procedure used for diagnosis or treatment that involves incision; puncture; entry into a body cavity; or the use of ionising, electromagnetic or acoustic energy).

Mr C said that the board unreasonably discharged Mrs A from hospital following her initial admission. We found that, at the point Mrs A was discharged, there were no clinical indicators to suggest that this was the wrong decision and, based on what was recorded in the nursing and medical notes at that time, she appeared to be improving at that stage. We did not uphold this aspect of the complaint.

Mr C also said that the board failed to provide Mrs A with appropriate care and treatment following her readmission to hospital. We found that the decision to undertake a scan-guided drainage of Mrs A's abscess was reasonable in the circumstances in order to improve her condition, which was very serious at the time, and to avoid major surgery to her chest. The procedure was a technically difficult one, but it was clinically successful because it did lead to draining of the abscess. The catheter becoming dislodged during this is a common problem with any drainage procedure and it was not possible to conclude that the blood clot that developed was either a result of the procedure itself, or the dislodging of the catheter, rather than a result of Mrs A's condition at that time. We did not uphold this aspect of Mr C's complaint.

Lastly, Mr C complained that the board failed to respond appropriately to his letter of complaint about Mrs A's care and treatment. We recognised that Mr C did not agree with the response the board gave about why Mrs A was discharged. However, we considered that the board accurately identified Mr C's concern and provided a reasonable response, which was an accurate reflection of what was recorded in the medical records. We considered that the board provided a general response to a specific question Mr C asked about Mrs A's discharge, by acknowledging that there had been a difference in recollections and that this was something that the board would strive to improve. Therefore, we did not uphold this aspect of the complaint.