Not upheld, no recommendations

Summary

Mrs C complained about the care and treatment provided to her late husband (Mr A). Following surgery to remove a tumour on this lung, Mr A was treated for atrial fibrillation (AF - an irregular and usually rapid heart rhythm) with amiodarone (an antiarrhythmic drug). Mrs C complained that the board unreasonably prescribed amiodarone as a first line treatment for Mr A's AF. Mrs C noted that patients prescribed with amiodarone after thoracic (chest) surgery are vulnerable to side effects, and she considered Mr A would have survived had a less dangerous drug been used to treat him.

We took independent clinical advice from an adviser. We found that guidance supported the use of amiodarone at the time of Mr A's treatment as it is the drug most likely to restore normal heart rhythm and thereby avoid the consequences of low blood pressure, heart failure or stroke, and its use remains common. We acknowledged that amiodarone may not always be the most appropriate first line treatment option in all cases of AF, however, we were satisfied that it was reasonable for medical staff to reach the view that the benefits of treatment with amiodarone outweighed the risks in Mr A's case. Therefore, we did not uphold Mrs C's complaint.

However, we provided some feedback to the board that, despite referring to it on a number of occasions in their response to Mrs C's complaint, they did not have a written protocol on treating post-operative AF following lung surgery. We suggested the board may wish to review their practice on the routine use of amiodarone as a first line therapy in all cases of post-operative AF, and consider producing a protocol on the management of AF after thoracic surgery. We also provided feedback with respect to the content and lack of accuracy of the board's response to Mrs C's complaint and invited the board to make a further apology to Mrs C having reflected on the findings of our investigation and feedback with respect to their complaints handling.

Summary

Mr C complained about the treatment which his child (Child A) received at Forth Valley Royal Hospital. Mr C said that Child A had been unwell for many months following a viral diagnosis and that they had continued to experience symptoms which had affected their life, including missing school for multiple periods. Although Child A had been referred to otorhinolaryngology (medical treatment of ear, nose and throat) and paediatrics (medical care of children), Mr C felt that a diagnosis should have been reached after such a long time.

We took independent advice from a consultant paediatrician. While there was a lack of advice and support provided to Mr C on how to manage Child A's symptoms in the interim, which would have helped to allay their fears, we found that appropriate investigations and assessments had been carried out in an effort to arrive at a diagnosis, including referrals to specialist services. We did not uphold the complaint.

Summary

Mrs C complained about the nursing care provided to her cousin (Mr A) during an admission to Forth Valley Royal Hospital. Mrs C raised concerns about various aspects of the nursing care provided to Mr A in respect of his hygiene and whether he was being provided with appropriate support to eat and drink properly.

We took independent advice from nursing adviser. We found that there were daily entries in the nursing notes to indicate Mr A's needs were met. We noted that the care plan documentation had not been completed until some time after admission. However, while it would be good practice to do so earlier, this does not necessarily mean the nursing care provided was not of a reasonable standard. We acknowledged that the account provided in the nursing records was not Mrs C's experience. However, we did not consider there to be independent evidence that could verify her view. Therefore, based on the available evidence, we did not uphold this complaint.

Mrs C also complained about communication issues she experienced as Mr A's power of attorney. The board had previously provided an apology for Mrs C's experience but there were still a number of areas Mrs C was unhappy about. On balance, we concluded that staff's communication with Mrs C was reasonable in the context of a busy hospital environment. We acknowledged that communication was not as good as it could have been, but we did not consider it to be unreasonable. We provided some feedback to the board but, on balance, did not uphold the complaint.

Summary

Ms C, an advocate, complained on behalf of her client (Ms A) about the treatment which Ms A received at the practice. Ms A had reported concerns about hip pain on a number of consultations, but the GPs wrongly diagnosed a soft tissue injury when Ms A had actually suffered a fracture of the hip.

We took independent advice from a GP. We found that Ms A had an extensive medical history of hip problems and was under the care of the orthopaedic (conditions involving the musculoskeletal system) team. When Ms A reported hip pain following a fall it was not unreasonable for the GPs to conclude that Ms A had suffered a soft tissue injury as she was able to weight bear. Although it would appear that the fracture had occurred by the time Ms A was seen by the GPs, this was not an indication that the care and treatment was unreasonable. We did not uphold the complaint.

Summary

Ms C attended hospital for minor surgery under anaesthetic. She said that she made it very clear in advance of attending for the surgery that she did not want to have any opioid drugs (common pain relief) administered. However, despite communicating that prior to and on the day of surgery, an opioid was administered whilst Ms C was under anaesthetic. Ms C also had concerns about the staff present in the anaesthetic room. She said no one introduced themselves or explained their role to her; she did not know who one individual was even though they squeezed her arm as a method of tourniquet (device for stopping the flow of blood through a vein or artery) during the insertion of the cannula; and she questioned the appropriateness of the method of tourniquet used.

We took independent advice from a clinical adviser. It was noted that staff denied not having introduced themselves to Ms C. They said they had acknowledged Ms C's anxieties and to help with that she was moved to first on the theatre list. We also reviewed a patient leaflet produced by the Faculty of Pain Medicine which indicated that squeezing a patient's arm was an acceptable method of tourniquet.

In turning to Ms C's concern that she was administered an opioid against her expressed wishes, the board confirmed the anaesthetist was aware of Ms C's previous unpleasant experience with morphine and recalled reassuring her that they would not use that drug or any long acting opiates. They were not aware that Ms C wished to avoid all opioids. We found that it would have been unreasonable not to administer pain relieving drugs to Ms C during her surgery, because she could have suffered acute pain and distress.

Finally, we were satisfied that the board had taken reasonable steps to identify the staff present in the anaesthetic room. In light of the information we saw in Ms C's case, we did not uphold the complaints.

Summary

Mrs C complained about the treatment which her daughter (Miss C) received at Borders General Hospital. Miss C had injured her hand, and nerve conduction studies showed there was evidence of nerve damage. Mrs C felt that there was a delay by the consultant in treating the injury and that the option of surgery should have been considered.

We took independent advice from a consultant orthopaedic surgeon (a specialist in the treatmentof diseases and injuries of the musculoskeletal system). We found that the consultant had reached a diagnosis of brachial neuritis (pain or loss of function in a nerve) which was reasonable and that it was appropriate to treat the condition conservatively rather than with surgery. It was also noted that there was an improvement in Miss C's condition. We did not uphold the complaint.

Summary

Ms C complained that the university had failed to take into account all relevant information during the appeals process. Having reviewed the evidence, we were satisfied that all of the evidence was considered in line with university procedures during the appeals process. We did not uphold Ms C's complaint.

Summary

Mr C complained on behalf of his client (Mr A) that the council failed to deal properly with a development on land adjacent to that which Mr A owned. Mr C said that the council failed to carry out a traffic impact assessment (TIA), to confirm if a road was adopted and to deal with his complaint properly.

We took independent planning advice. We found that the council were entitled as a roads authority to exercise their discretion over requesting updates to the TIA. In addition, the council had imposed a planning condition to regulate traffic flow. We also found that the council had provided Mr C and Mr A with all the information they were legally required to hold and they had acted reasonably. We considered that the council could demonstrate that they had responded reasonably to Mr C's complaint, and that his disagreement with the council's decision was not evidence of maladministration. Therefore, we did not uphold Mr C's complaints.

Summary

Mrs C complained that the council failed to follow relevant procedures after an incident occurred at her child's (Child A) school. Mrs C was concerned that an ambulance and the police were not called immediately after the incident, and that appropriate support was not in place for Child A's return to school.

We found that it was a discretionary decision for the council on whether to call the emergency services based on their assessment of the situation at the time. We did not find evidence of an administrative or procedural failure on the part of the council which would lead us to question their decisions. We did not uphold Mrs C's complaint.

Summary

Mr C complained about the council's decision to significantly increase fees for musical tuition. He considered the council had not followed due process, in that there had been insufficient consultation on the decision, or assessment of the impact the decision would have.

We found that the council had held a number of public consultation meetings relating to their proposed budget and that there was recorded evidence to show that musical tuition was raised at some of these. We also found that they had carried out an appropriate equality impact assessment on the decision, which did not highlight any equality concerns. Overall, we were satisfied that the council had reasonably complied with their policies and procedures before reaching the decision. Therefore, we did not uphold Mr C's complaint.