Not upheld, no recommendations

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.

Summary

C complained that the board had unreasonably stopped their medication in prison. We took advice on the complaint from a medical adviser. The medication had been stopped after a check had been carried out and it had been found that some of C's medication was missing. We found that it had been reasonable to stop the medication and that the care provided to C had been reasonable. Medical staff had acknowledged C's mental health conditions and had directed them to engage with the mental health team. We did not uphold the complaint.

Summary

Mr C complained about the treatment which he received at the Ear, Nose and Throat (ENT) Department at Queen Margaret Hospital. He had been referred by his GP for further investigation of hearing loss. Mr C said that he also had discharge from his ears. He said that the consultant had told him to leave his ears alone as they were fine and did not prescribe any drops or medication. Mr C then attended his GP later that day and a swab was taken and he was prescribed capsules and cream until the results were known. The swab result confirmed an infection and antibiotics were prescribed. Mr C felt that the consultant had dismissed his concerns about the discharge from his ears.

We took independent advice from an ENT consultant. We found that the consultant in the ENT Department had carried out an appropriate examination to establish the cause of Mr C's hearing loss. It was also not unreasonable that the consultant had determined Mr C had caused trauma to his ear canals by using cotton buds and gave advice to stop using them and to wait to see if the inflammation settled in due course. At that time it was not appropriate to issue antibiotics. We did not uphold the complaint.

Summary

Miss C complained about a number of aspects of the care and treatment her mother (Mrs A) received at Victoria Hospital.

We took independent medical advice from three advisers – a consultant radiologist (a doctor who specialises in diagnosing and treating disease and injury through the use of medical imaging techniques such as x-rays and other scans), a consultant gynaecologist (a doctor who specialises in the female reproductive system) and a consultant colorectal surgeon (a surgeon who specialises in conditions in the colon, rectum or anus).

Miss C said that a radiologist failed to identify the thickened area in part of her mother's bowel on a CT scan. We found that an opportunity was missed at the time of the reporting of Mrs A's CT scan to identify a tumour in this area, in addition to making the new diagnosis of an ovarian tumour. However, given the limited sensitivity and specificity of unprepared CT scan for bowel tumours, we consider this not to be unreasonable.

Miss C complained that there was a delay in Mrs A's hysterectomy (surgical removal of the uterus) taking place which she said was due to the gynaecologist's leave delaying Mrs A's case being discussed at the multi-disciplinary team meeting. We found that Mrs A was referred for her case to be discussed at the next gynaecology multi-disciplinary team meeting the day after she was admitted to hospital. This was then processed in accordance with the department's normal procedures and Mrs A's case was discussed at the next available multi-disciplinary team meeting. We considered that the consultant gynaecologist's leave was not relevant to Mrs A's care and did not delay it in any way.

Miss C said that following the results of Mrs A's CT scan and the suspicion of cancer, the board should have carried out Mrs A's colonoscopy (examination of the bowel with a camera on a flexible tube) and PET scan while she was still in hospital. We found that Mrs A's colonoscopy was carried out within appropriate timescales, taking into consideration the risks from her previous surgery, her potential pain/discomfort and the likely success of the procedure. We found that Mrs A's PET scan was also carried out within a reasonable time, allowing for tissue healing and resolution of infection to take place following Mrs A's surgery, and in order to produce meaningful results to assist clinical decision-making and patient management. The timescales for these procedures would have had no impact on the treatment provided.

We did not uphold this complaint.

Summary

C complained that the care and treatment they received at Borders General Hospital was unreasonable, including that they should not have been admitted; that they were not advised of the side effects of their medication; and that staff did not adequately explain what the medication was to treat.

We took independent advice from an adviser qualified in psychiatry. We found that it was appropriate for C to be admitted to hospital for assessment and treatment. While we found that there was no evidence of a specific discussion with C regarding the potential side-effects of their medication, we considered that the board's acknowledgement and apology for this in their letter to C to be a reasonable response. We found that, overall, there was good evidence of engagement and dialogue with C regarding their treatment plan and medication, and that the board's prescribing and administering of medication was reasonable. As a result, we did not uphold the complaint.

Summary

Mrs C attended hospital for a coronary angiogram (a test to find out if a person has any problems with the blood vessels that supply the heart muscle with oxygen and how well the pumping chambers and valves in the heart are working).

Following the procedure, Mrs C was left feeling pain in her right leg and described her right foot as feeling frozen. A procedure was carried out to try and alleviate Mrs C's symptoms but she felt no improvement. Mrs C complained that the angiogram was not carried out to an appropriate standard. In responding to Mrs C's complaint, the board apologised but explained that she appeared to have suffered known complications of the procedure.

We took independent advice from a consultant cardiologist (a specialist that deals with diseases and abnormalities of the heart). We found that Mrs C's procedure was carried out to an appropriate standard. Therefore, we did not uphold the complaint.