Not upheld, no recommendations

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.

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.