Not upheld, no recommendations

Summary

Mr C complained that there was an unreasonable delay in diagnosing his late mother (Mrs A) with cancer. Mrs A had a number of consultations in the respiratory clinic at University Hospital Monklands and had a background of chronic obstructive pulmonary disease (a type of lung condition that causes breathing difficulties) and bronchiectasis (a long-term condition where the airways of the lungs become abnormally widened). During the period of care under consideration, Mrs A experienced an increase in frequency of chest infections, and her chest x-ray results showed progressive changes.

We took independent advice from a consultant in respiratory medicine. We found that it was reasonable to consider that the progressive changes, and increase in symptoms, to be part of the progression of Mrs A's lung disease. In this context, we found that it was reasonable that investigations were not arranged earlier. We did not find that there had been a delay in diagnosing Mrs A's cancer and therefore we did not uphold Mr C's complaint.

Summary

Mrs C complained about the treatment she received at the practice to have a leg wound dressed. Mrs C said that she attended on a number of occasions and told nursing staff that the wound was sore and infected but that they ignored her concerns. Subsequently, one of the nurses arranged for a swab to be taken and this identified that the wound had become infected. Mrs C felt that the nursing staff should have acted on her concerns earlier and that it would have saved her the additional pain and distress.

We took independent advice from a nurse. We found that the nurses involved provided appropriate wound care and that there were no recorded signs of infection. A swab was taken because of slight inflammation of the wound which subsequently identified an infection which was treated with antibiotics. We did not uphold the complaint.

Summary

C complained about the treatment provided to their child (A). A was admitted to hospital with a worsening lung infection, linked to their genetic disorder, and was found to be in acute kidney failure. As part of a number of tests, it was found that A's ferritin levels were very high, and when this was identified by the clinicians involved in A's care, A was diagnosed with an uncommon and serious problem with their immune system. A died from the condition. C complaind that the ferritin test results were not acted on in a reasonable timescale to provide appropriate treatment.

We took independent advice from a consultant nephrologist (doctor specialising in internal medicine that focuses on the treatment of diseases that affect the kidneys). We found that, overall, the treatment provided to A was reasonable. It was reasonable that the ferritin test was not actively sought out by A's clinicians as it was not considered to be crucial in treating A's acute illness. We found that there was nothing to indicate the very rare condition before the ferritin result, and that this was not an expected part of the management of an acute illness. We did not uphold C's complaint.

Summary

Miss C, an advocate, complained on behalf of her client (Ms A) that the board had decided, from an urology (the branch of medicine and physiology concerned with the function and disorders of the urinary track) perspective, there was no reason to refer Ms A for an immunology (the branch of medicine and biology concerned with immunity) opinion.

We took independent advice from a consultant urologist. We found that the care and treatment given to Ms A was reasonable, and that appropriate advice had been given in relation to her condition. We also found that Ms A had not completed the investigations necessary to diagnose her condition and that, in these circumstances and from an urology perspective, there was no reason to refer Ms A for an immunology opinion. Therefore, we did not uphold Miss C's complaint.

Summary

Mr C complained about the care and treatment provided by the practice in respect of his ongoing knee pain. He attended two consultations with knee pain and had requested to be referred to the orthopaedic (conditions involving the musculoskeletal system) clinic and for a multi-resonance imaging scan (MRI) to be carried out. However, at the first consultation, the practice prescribed anti-inflammatory medication and provided advice regarding exercise and knee care. At the second consultation, the practice arranged for x-rays to be carried out and advised Mr C to make a self-referral to physiotherapy.

Based on Mr C's presentation, the practice concluded that the source of the pain was likely to be osteoarthritis (the most common form of arthritis, usually occurring in older people, with chronic breakdown of cartilage in the joints leading to pain, stiffness, and swelling or the most common form of arthritis that affects the joints). The x-ray results confirmed this but the results were not relayed to Mr C. Years later, Mr C attended a further consultation and the practice made a referral to the orthopaedic clinic. At the time of making his complaint to the SPSO, Mr C was still on the waiting list to be seen at the orthopaedic clinic. This was partly due to the fact that the practice did not consider it appropriate to make an urgent referral. In Mr C's view, the practice unreasonably delayed in referring him to the orthopaedic clinic and for an MRI scan.

We took independent advice from a GP. We found that Mr C received appropriate care and treatment for his knee pain. This care and treatment was in line with the Scottish National Knee Pain and Management Pathway, produced by the Scottish Government. We recognised that Mr C was concerned that the practice did not contact him following his x-ray or physiotherapy appointment. However, we did not consider this to be unreasonable or out of line with the procedures of other practices. We did not uphold Mr C's complaint.

Summary

C complained about the care and treatment they received from the board during their admissions to Royal Alexandra Hospital and the board's communication with them during and after admission.

C considered that staff did not take into account their medical history or presenting symptoms and failed to offer appropriate treatment or consult relevant medical professionals. C also considered that the board failed to communicate reasonably with them in that staff were dismissive and patronising. C said that they were not given information as available and staff presented as reluctant to provide information. Furthermore, C considered that communication following discharge was unreasonable as C stated that they had been told that a member of staff from the board would contact them with follow-up but C received no further contact.

We took independent advice from advisers in the areas of emergency medicine and general surgery. We found that there had been no failures in the care and treatment provided to C. We found that C received reasonable care and treatment; in particular, their medical history and presenting symptoms were fully considered and appropriate treatment provided.

We found that there was no evidence to support C's assertion that the board's communication with them was below the standard that would have reasonably been expected.

Therefore, we did not uphold C's complaints.

Summary

Mrs C, a support and advocacy worker, complained on behalf of her client (Miss B). Miss B was concerned that her mother (Mrs A) had been discharged prematurely from Royal Alexandra Hospital. Mrs A had been discharged the day after her admission. Mrs A deteriorated suddenly following her discharge and died the following day.

Miss B believed that Mrs A had not been well enough to be discharged. In particular she felt that her mobility was not properly assessed, as Mrs A was reviewed by medical staff whilst sitting in a chair. Additionally, Miss B had raised concerns with the board about comments made to her and Mrs A about other patients needing a bed, requiring Mrs A's discharge.

We found that the board had already conducted a serious clinical incident review, which had focussed on the issue of comments by nursing staff. Miss B wanted us to review the decision to discharge Mrs A and in particular the assessment of her.

We received independent medical advice. We found that the decision to discharge Mrs A was reasonable and that her deterioration could not have been anticipated. We did not uphold this complaint.

Summary

Following lower back surgery, Mr C complained about pain in his mid-back which had not been there before. Further reviews of Mr C's symptoms were carried out by the orthopaedic (conditions involving the musculoskeletal system) department and the pain clinic but the cause of his pain, and the pain itself, was not resolved. Mr C considers that his original surgery was not carried out properly and that something went wrong to cause his pain.

The board confirmed that Mr C's original surgery was carried out to alleviate leg pain. They said guidelines stated that surgeons should not operate for back pain alone and confirmed that further surgery in Mr C's case was unlikely to help. The board explained that Mr C had been reviewed by a different orthopaedic consultant, and a second opinion had been sought from a consultant in another board area, both of whom agreed that further surgery would not help the symptoms of pain in Mr C's back.

We took independent advice from an orthopaedic consultant. We found reasonable history and examinations of Mr C were carried out and that appropriate scans and referrals were made. We concluded that the board provided appropriate treatment in view of Mr C's presenting symptoms. We did not uphold Mr C's complaint.

Summary

Ms C, an advocacy worker, complained on behalf of her client (Ms A) about the care and treatment provided to Ms A's late mother (Mrs B) by the practice following a home visit by a doctor from the out-of-hours (OOH) service. Mrs B was later admitted to hospital where she died.

We took independent advice from a GP. We found that there was no indication, based on the report from the OOH doctor, for the practice to arrange an emergency home visit to Mrs B or that the OOH doctor had requested the practice carry out a home visit. There was also no evidence to suggest that Mrs B was deteriorating in the days following the visit of the OOH doctor.

We found that the subsequent sudden deterioration in Mrs B's condition could not have been foreseen and the care provided by the practice following the visit from the OOH doctor, and the plan to visit Mrs B as a routine house visit, was reasonable and consistent with good medical practice.

Therefore, we did not uphold the complaint.

Summary

C underwent a polypectomy (a procedure used to remove polyps from the inside of the colon). C said that they informed staff prior to the procedure that they had a platelet disorder (platelets are the cells responsible for making blood clot. A platelet disorders mean that injured blood vessels bleed more than usual and heal more slowly), however, no precautions were taken prior to the polypectomy being carried out. C later experienced bleeding. C complained that the board unreasonably managed their care in relation to their history of a platelet disorder and failed to reasonably manage their care after they were admitted with bleeding.

We took independent medical advice. We found that clinicians undertook a pre-assessment with C. While C had a history of experiencing bleeding as a child, a more recent operation had not resulted in significant bleeding. We found that it was reasonable that no further tests were carried out prior to the procedure being undertaken, as there was full blood count and clotting information available to clinicians which would have highlighted any long standing problem with the number of platelets if there were any. We did not uphold this aspect of the complaint.

We found the board's management of C in the acute situation was adequate and carried out in a reasonable timescale. There was no indication a specific platelet or clotting factor transfusion was required. We did not uphold this aspect of C's complaint.