Not upheld, no recommendations

Summary

Ms C complained that the university did not carry out a reasonable investigation into her complaints. In particular, Ms C was concerned that the university did not take all the relevant evidence into account, did not interview all the relevant parties and did not follow the right policies/procedures.

We found that the university had reasonably followed their complaints handling procedure, considered all the relevant evidence and made reasonable attempts to interview the witnesses specified by Ms C. While we appreciated that Ms C disagreed with the university's decisions regarding her complaints, her disagreement with their interpretation of matters and their decisions is not, of itself, evidence of an administrative failing on their part. We considered that the university's investigations into Ms C's complaints were reasonable and did not uphold Ms C's complaint.

Summary

Mrs C complained that the council had handled a planning application unreasonably. She noted that there were a number of admitted errors, which she said materially affected the conclusion reached by the planning officer.

We took independent planning advice and found that although the council had acknowledged these errors, they were not sufficient to consider the council acted inappropriately or unreasonably. The council had provided detailed explanations for their decision and had been able to demonstrate that they were made on appropriate planning grounds. In addition we found some of the issues being raised by Mrs C, such as a boundary dispute with the developer, were in fact civil matters and could not be decided through the planning process. We did not uphold the complaint.

Summary

Mr C complained about the support provided to him by the council following his release on licence from prison. Mr C also complained about the content of a report that the council submitted to the Parole Board, requesting consideration of Mr C being recalled to prison. We took independent advice from a social worker. We did not find evidence that the council's decision-making or the support provided to Mr C was unreasonable. We did not uphold Mr C's complaints.

Summary

Mrs C complained that she and her family were unreasonably removed from the practice list of patients. Mrs C said that she had no trust in the service provided by the practice and that she had never received explanations about what diagnoses had been reached about her numerous medical conditions.

We took independent advice from a GP. We found that prior to removing Mrs C and her family from the patient list, the practice had repeatedly made an offer of a meeting with Mrs C to discuss her concerns. When Mrs C failed to accept the offers, the practice viewed the doctor/patient relationship had irretrievably broken down and that it was in Mrs C's best interests to register with another medical practice. The hope was that she could build up a good doctor/patient relationship with her new practice. We did not uphold the complaint.

Mrs C also complained that it was unreasonable to have her family removed from the patient list as well. Guidance suggests that members of a patient's family should not be removed automatically from the practice list where there is a breakdown in the doctor/patient relationship. However, in instances where children and/or carers are involved, it is appropriate to remove the whole family, as this will allow better communication and the sharing of information where all family members are registered with the same practice. Therefore, we did not uphold this complaint.

Summary

Mr C complained about the treatment which he received from the practice. He reported stomach and bowel problems to a number of GPs. They treated him for irritable bowel syndrome but they failed to diagnose that he had a bowel obstruction and that resulted in him having to have a colostomy (an operation to divert part of the bowel through an opening in the tummy) and undergo chemotherapy.

We took independent medical advice from a GP. We found that the GPs who treated Mr C carried out appropriate investigations in view of the stomach and bowel symptoms which he presented with. When Mr C reported passing blood the GPs made a referral for a colonoscopy (examination of the bowel with a camera on a flexible tube). However, before the colonoscopy could take place, Mr C was admitted to hospital as an emergency and was diagnosed with a bowel obstruction. We did not uphold the complaint.

Summary

Mrs C complained about the care and treatment provided to her late daughter (Ms A). Ms A had a history of breast cancer and she had been complaining of severe leg pain. She attended A&E to request an emergency MRI scan, however, she was advised by hospital staff that she did not meet the criteria for an emergency scan. An out-patient referral was made instead. Ms A was later diagnosed with cancer and underwent surgery to repair a cancer related fracture of her hip. Following the surgery, it was identified that Ms A had a neck fracture.

Mrs C complained that the hospital staff unreasonably refused to perform the MRI scan when Ms A attended A&E and that the board failed to provide a reasonable explanation for the cause of Ms A's neck fractures.

We took independent medical advice from an orthopaedic (conditions involving the musculoskeletal system) surgeon. We found that an emergency MRI scan can only be performed if the patient is suffering from a neurological deficit, therefore it was correct that Ms A was advised she did not meet the criteria. We also found that there was no evidence to suggest that Ms A's neck fracture occurred during surgery, and it was reasonable to conclude that the fracture developed due to the progression of the cancer into her bones. We did not uphold the complaints.

Summary

Mrs C complained about the treatment which her son (Mr A) received at Hairmyres Hospital. Mr A was admitted with severe stomach pains, vomiting of blood and blood in his stools. The diagnosis was a bleed within his intestinal tract. Initially the plans were that an endoscopy (a medical procedure where a tube-like instrument is put into the body to look inside) would be carried out while Mr A was a patient. Mr A was then discharged home after a few days and arrangements were made for him have an endoscopy as an out-patient within four to six weeks. A letter was issued to Mr A asking him to make contact for a date for the endoscopy, but he did not respond. He was then admitted to another hospital as an emergency where he underwent surgery for a perforated gastric ulcer (condition in which an untreated ulcer can burn through the wall of the stomach or other areas of the gastrointestinal tract). Mrs C felt that had Mr A received the endoscopy while an in-patient, it may have prevented the ulcer perforation.

We took independent advice from a surgeon. We found that while Mr A was in hospital the staff carried out appropriate investigations in order to arrive at a diagnosis. There is guidance that Mr A should have received an endoscopy while an in-patient. However, this would have been for the purposes of establishing whether Mr A was continuing to lose blood; but as Mr A showed signs of improvement, this was not the case. It was appropriate to discharge Mr A from hospital as he appeared to be stable, and the revised plan for an out-patient endoscopy was then reasonable in the circumstances. We did not uphold the complaint.

Although we did not uphold the complaint we highlighted issues of concern regarding record-keeping, risk assessment and communication with primary care as feedback to the board in an effort to improve learning.

Summary

Mr C complained that the practice had over-prescribed Diazepam and Nitrazepam (both belonging to a class of sedative medication called benzodiazepines) for a period of ten years. He believed that this had caused long-term damage to his mental health including aggression and anger. He said that the practice had failed in their care by not managing a controlled withdrawal.

We took independent advice from a GP. We found that Diazepam was being prescribed along with antipsychotic medication, as instructed and monitored by psychiatry. We noted that the practice closely monitored Mr C, made efforts to refer him to addiction services for Diazepam detoxification and, when he defaulted from the services, they monitored and gradually reduced his Diazepam within the practice. We found that the practice's management of his prescription was reasonable, and we did not uphold this complaint.

Mr C also complained that the practice unreasonably removed him from their practice list. The practice said he had been removed from their list due to aggressive behaviour, and that this was not the first instance of such. Mr C felt that this was unreasonable as he considered he had been displaying the symptoms of over-prescription of Diazepam and Nitrazepam.

We noted that the records showed Mr C was 'repeatedly harassing the reception staff' and had received previous warnings for inappropriate and aggressive behaviour. We confirmed that benzodiazepines are noted to have a rare side effect of aggression, but having reviewed Mr C's records going back 16 years, we found that suggesting his medication was the cause of his aggression was the least likely explanation. We noted from the records that there had been an irrevocable breakdown in the relationship between Mr C and the practice and we considered it reasonable to remove him from the list. We did not uphold this complaint.

Summary

Mrs C, an advice worker, complained on behalf of her client (Mrs A) who had concerns about the treatment which she received from a consultant rheumatologist (specialism of the medical treatment of the musculoskeletal and its disorders) at Raigmore Hospital. Mrs A had a leg ulcer and was being considered for treatment for her arthritis (a disease causing painful inflammation and stiffness of the joints). She requested that the board provide her with a certain medication that she had identified when researching the internet. However, the board refused as the requested medication could not be used as first line treatment until alternative medication had been considered in the first instance.

We took independent advice from a consultant rheumatologist. We found that the decision not to provide the requested medication until alternative first line medication had been attempted was reasonable and in line with accepted medical practice. We did not uphold the complaint.

Summary

Mr C complained about the treatment he received at Queen Elizabeth University Hospital when he attended for a kidney biopsy. Mr C said that the doctor performing the procedure was unsuccessful in obtaining the tissue sample and that a consultant had to complete the procedure. Mr C subsequently went on to suffer a bleed from the site of the biopsy and required a blood transfusion. Mr C felt that the procedure may have been carried out incorrectly.

We took independent advice from a consultant nephrologist (doctor specialising in medical treatment of the kidneys). We found that Mr C had suffered from a recognised complication of the kidney biopsy procedure. Initially the procedure was carried out by a trainee under consultant supervision but when difficulties were encountered, it was appropriate for the consultant to complete the procedure which was successful. While minor bleeding can occur at the site of the biopsy needle, on occasions more significant bleeding can happen. This was the case with Mr C, and it was not an indication that the procedure had been carried out incorrectly. We also found that the risks of the procedure were explained to Mr C and appropriate consent was obtained. We did not uphold the complaint.