Not upheld, no recommendations

Summary

Mr C complained about the treatment provided to his late father (Mr A). Mr A had complained about poor memory and poor balance over a number of weeks. The board carried out a number of investigations, however, due to the wait for follow-up appointments, Mr A decided to seek private treatment and he was subsequently diagnosed with Creutzfeldt-Jakob Disease (CJD - a rare degenerative brain disorder). Mr C complained that the board failed to carry out the appropriate investigations, and that the board inappropriately discharged Mr A when his condition was getting progressively worse.

The board confirmed they were satisfied that the appropriate investigations were undertaken. They acknowledged that they could not offer Mr A an earlier appointment and explained that this was due to the service being understaffed.

We took independent advice from a consultant neurologist (a doctor who specialises in the brain and nervous system). We found that the appropriate investigations were carried out. Due to the nature of Mr A's condition, a number of conditions had to be ruled out first and there is no single test that can be performed in order to reach a diagnosis. The board subsequently informed us that the staffing issues have since been resolved. We also considered that it was appropriate to discharge Mr A as the risks of complications was much lower at home than in hospital. We did not uphold Mr C's complaints, however, feedback was provided regarding the board's communication with the patient and his family and the manner in which Mr A was prioritised.

Summary

Ms C complained about the care and treatment provided to her by the practice for a number of symptoms over period of several months. We took independent advice from a GP. We found that the assessments, investigations, referrals and treatment provided to Ms C were reasonable. We did not uphold the complaint.

Summary

Mr C was admitted to A&E following a road traffic accident. He was concerned that inadequate investigations were carried out to determine the extent of his injuries. Following an MRI scan, it was found that Mr C had a neck injury which required surgery. Mr C also felt his complaints of pain were minimised and often ignored by staff.

We took independent advice from an emergency medicine consultant. We found that proper assessments and investigations were carried out in light of the injuries Mr C presented with. We had no concerns about the way staff managed Mr C's reports of pain and that he was given appropriate pain relief. We found that there was no indication that an MRI of Mr C's neck should have been carried out sooner. MRI scans are required to identify injuries to the soft tissues in the neck or the spinal cord and are normally only carried out when patients have symptoms consistent with spinal cord injury or when, in the presence of a normal CT scan, there is a significant suspicion of a ligamentous injury. In Mr C's case, it was noted that when he displayed a foot drop and weakness in his hand, the decision was taken to obtain an MRI scan.

We found that the board provided reasonable care and treatment for Mr C's neck injury and, therefore, we did not uphold the complaint.

Summary

Ms C complained that the care and treatment she received from the practice was unreasonable. Ms C attended the practice on a number of occasions complaining of a sore lump. She was referred to the treatment room (the treatment room is staffed by nurses who are trained and specialise in wound care) for assessment and management of a post-operative wound she had. Ms C also attended the hospital and was informed she had cellulitis (an infection of the deeper layers of skin).

We took independent advice from a GP. We found that the practice had assessed Ms C's wound, arranged an appropriate referral to the treatment room and arranged appropriate treatment. We did not uphold the complaint.

Summary

Mr C complained about the care and treatment he received from a number of different clinical areas provided by the board. In particular, Mr C raised concerns about the care and treatment he received while he was a patient of the Physical Disability Rehabilitation Unit, the treatment he received from occupational therapy and the treatment of his urine infections and acid reflux symptoms.

We took independent advice from a physiotherapist, an occupational therapist, a consultant urological surgeon and a neurologist regarding Mr C's concerns. We did not find any failings regarding the care and treatment Mr C received.

We did not uphold Mr C's complaint.

Summary

Ms C complained about the care and treatment she received at Princess Royal Maternity Unit and Queen Elizabeth University Hospital following the birth of her baby. Ms C complained about the appropriateness of a speculum (a metal instrument that is used to dilate an orifice or canal in the body to allow inspection) examination and had concerns whether an ultrasound had been carried out and reported properly. Ms C also complained that it took around three weeks for it to be identified that she needed surgical treatment for ongoing bleeding and retained products of conception, and about the lack of breast pump available and support given regarding expressing milk.

We took independent advice from a consultant obstetrician and gynaecologist (a doctor who specialises in pregnancy, childbirth and the female reproductive system) qualified in ultrasound, a consultant obstetrician and gynaecologist, and a midwife. We found that it was appropriate to perform the speculum examination and that the ultrasound had likely been interpreted accurately. Therefore, we did not uphold this aspect of Ms C's complaint.

We also found that subsequent investigations did not identify significant products of conception that required earlier surgical intervention. We further considered that there was reasonable evidence to reflect that advice had been offered regarding breast care and that it was not unreasonable that a breast pump was not available at the time of discharge. However, we noted that the board reflected on Ms C's concerns and acknowledged the benefit of improving their supply of breast pumps. We did not uphold this aspect of Ms C's complaint.

Summary

Mr C complained about the care and treatment provided to his child (Child A) during an admission at Royal Aberdeen Children's Hospital. Child A had a life-limiting condition, including heart and lung problems which made them susceptible to infection. Mr C complained that the hospital did not monitor Child A's blood gases frequently enough which led to an unreasonable delay in them being intubated. Mr C also complained that the hospital failed to accept a referral to the respiratory department. The board confirmed that they performed monitoring of Child A's blood gases when it was clinically indicated. They also confirmed they could not find any evidence of a formal written referral to the respiratory department.

We took independent advice from a consultant paediatrician (consultant specialising in the medical care of children). We found that appropriate monitoring of Child A's blood gases was performed, particularly for in a high-dependency unit setting. We did not find any evidence that the board failed to act upon a referral to respiratory. We did not uphold Mr C's complaints.

Summary

Mr C complained about the lack of care which his wife (Mrs A) received from the Victoria Hospital Kirkcaldy. Mrs A had suffered from chronic knee pain for a number of years and had undergone episodes of arthroscopy (surgical technique to diagnose and treat problems in the knee joint) in the past. She requested further surgery but the surgeon decided that further surgery would not be of benefit and that she should continue with conservative treatment. Mrs A asked for a second opinion and another consultant discussed Mrs A's condition with the surgeon; it was again decided to continue with conservative treatment. Mr C thought that the decision of the surgeon was unreasonable and that they had influenced the decision from the consultant.

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 the decision by the surgeon not to offer further surgery was reasonable in the circumstances. If a patient still suffers from pain following repeated arthroscopic surgery, it would not be appropriate to continue with the surgical interventions when there is no notable benefit for the patient. We also found that it was not unreasonable for the consultant and the surgeon to have discussed treatment options for Mrs A and that the decision to persevere with conservative treatment was appropriate. We did not uphold the complaint.

Summary

Mr C complained about the care his mother-in-law (Mrs A) received at Victoria Infirmary Hospital. Mrs A has emphysema (a lung condition that causes shortness of breath) and has particular difficulty with her breathing when moving around. Mr C raised concern that when he made enquiries about Mrs A receiving ambulatory oxygen therapy (the use of supplementary oxygen during exercise and activities of daily living) it was unreasonably refused.

We took independent advice from a consultant physician in general and respiratory medicine. We found that it was reasonable for board staff to have reached the view that ambulatory oxygen was not indicated in accordance with guidance issued by the British Thoracic Society. We, therefore, did not uphold the complaint. However, we also considered that board staff should have offered Mrs A a second opinion and so we provided feedback to the board for reflection in this respect.

Summary

Miss C complained about the treatment which she received from a dentist. She said that she had attended the dentist over a five month period complaining of a sore tooth and that the dentist told her she required eight fillings. Miss C said that following the treatment she still suffered sensitivity and discomfort from the treated teeth and that when she attended another dentist she was told that the fillings were not required.

We took independent advice on Miss C's complaint from a dentist. We found that there was evidence from Miss C's x-rays that decay was present in her teeth and that treatment was required. Although Miss C had not reported problems with some teeth, it did not mean that there was no decay present and that, if the decay was not too deep, it is not uncommon for dentists not to record the depth of the decay. There was no evidence to substantiate the complaint that the dentist failed to provide Miss C with a reasonable standard of treatment. We did not uphold the complaint.