Not upheld, no recommendations

Summary

Mr C attended the Western General Hospital after he experienced seizures. They carried out scans, which showed a lesion (an abnormal growth) in his brain. Mr C complained that there was a delay in diagnosing that it was brain cancer, as medical staff initially thought that the lesion was an abscess (a collection of infected fluid). We took independent advice from a consultant oncologist (cancer specialist). We found it was reasonable that Mr C's lesion was thought to be an abscess, given the results of the scans and his medical history. We found that it was good practice that they also tested the lesion for cancer. We did not uphold this aspect of the complaint.

Mr C also complained that when cancer treatment options were discussed with him, he was not given appropriate support. In addition, he complained that there was a delay in telling him about fertility options before he started his cancer treatment. We found that Mr C had appropriate support from the multidisciplinary team and his family when treatment options were discussed with him. We also found that he was given appropriate written information about fertility options. Therefore, we did not uphold these aspects of the complaint.

Summary

Mrs C complained about the treatment provided to her husband (Mr A). Mrs C said that the board unreasonably removed Mr A's right kidney and ureter (the duct by which urine passes from the kidney to the bladder) on the basis of a diagnosis of cancer.

We took independent advice from consultants in urology (the medical specialism that deals with the male and female urinary tract, and the male reproductive organs) and pathology (the study of disease). We found that there were failings in relation to record-keeping which we drew to the board's attention. We also found that there had been a delay in the surgery being carried out which the board had apologised for. However, we found the investigations carried out which led to the diagnosis of cancer were reasonable. We also found that the biopsies (tissue samples) taken in this case were appropriately interpreted at the time and that a mistake had not been made. Therefore, we did not uphold the complaint.

Mrs C also raised concerns about the Significant Adverse Event Review (SAER) which had been carried out. We found that the SAER carried out was reasonable. We found that a comprehensive review of the case was carried out, and failings in the consenting process were recognised. We also found that there had been a thorough external review of the pathology slides and recommendations made for improvements. We did not uphold the complaint.

Summary

Ms C complained about the care and treatment that her mother (Ms A) received at University Hospital Hairmyres. Ms A attended the hospital with back and chest pain, and her blood count was found to be low. The cause of Ms A's low blood count was suspected to be an internal bleed. Ms C was concerned about the investigations carried out to identify the cause of Ms A's low blood count and that Ms A was discharged home without a final diagnosis.

We took independent advice from a consultant hepatologist (specialist treating the liver, gallbladder and pancreas) & gastroenterologist (treatment of the stomach and intestines). We found that the clinical approach used to identify the source of Ms A's bleeding was reasonable. In particular, plans were made for Ms A to have an endoscopy (procedure using an instrument to give a view of the body's internal parts) and a colonoscopy (procedure where a flexible fibre-optic instrument is inserted through the anus in order to examine the colon) on an

out-patient basis. We found that it was reasonable for the board to discharge Ms A and that it would not have been possible for the board to make a final diagnosis during Ms A's admission. We did not uphold Ms C's complaint.

Summary

Mr C complained about the care and treatment provided to him by the board in relation to a pacemaker implantation (a device that generates electrical impulses delivered by electrodes to contract the heart muscles and regulate the heart). After Mr C had his pacemaker implanted, he attended hospital on several occasions as he was aware of having palpitations (noticeably rapid, strong or irregular heartbeat). Some months after implantation, it was found that Mr C had a heart failure as a result of the pacemaker. Mr C raised concern that it took several months to detect the heart failure and take action on this.

We took independent advice from a cardiologist (a medical specialist who diagnoses and treats disorders of the heart). We found that the monitoring of Mr C's pacemaker was reasonable, and that no problems were identified during this monitoring. We found that Mr C was not experiencing any symptoms of heart failure and therefore there would have been no reason for the board to suspect this. We determined that the finding of heart failure was incidental, and when identified it was acted upon in a timely and appropriate manner.

We noted that the risk of heart failure was not outlined on the consent form for Mr C's pacemaker implantation and that this was technically a failing. However, we found that national practice does not currently reflect that this risk is not routinely included anywhere on consent forms in the NHS at this point. Therefore, while we considered that it may be good practice to raise the risk of heart failure when taking consent for pacemaker implantation, as the risk is not one that is nationally recognised or currently reflected in practice and guidance, we did not consider this to be a failing of the board with regards to required actions and reasonableness. We did not uphold this aspect of Mr C's complaint.

Mr C also complained about the board's communication with him regarding his pacemaker and heart failure. We found that communication was prompt and covered all issues reasonably. We did not uphold this aspect of Mr C's complaint.

Summary

Miss C complained that the board failed to recognise and treat problems with her nose. Miss C was seen by consultants at both Wishaw General Hospital and Monklands Hospital but felt that her problems were ignored.

We took independent advice from an ear, nose and throat surgeon. We found that the assessments and conclusions reached by the consultants who reviewed Miss C were reasonable, and took into account her concerns. We considered that the treatment provided was in line with the findings of the assessments carried out. Therefore, we did not uphold the complaint.

Summary

Mrs C's complaint concerned the care and treatment given to her late husband (Mr A) by his GP practice. Mr A first attended the practice with lower back pain but later attended with testicular pain. After an examination he was informed that there was suspicion of prostate cancer. An urgent referral was subsequently made by his GP and he was advised that there was a high risk that he had prostate cancer which had spread. Mr A later died. Mrs C complained that the practice had failed to properly investigate Mr A's testicular and back pain, and that their referral letter misrepresented the situation. Mrs C also complained that Mr A had been prescribed morphine which caused hallucinations and that no palliative care plan had been made for him.

We took independent advice from a GP. We found that Mr A was treated reasonably and appropriately; there had been no delay in his diagnosis and an urgent referral had been made in a timely way. There was no evidence of misleading information in the referral letter and it was in line with General Medical Council Good Medical Practice. We also found that morphine could cause side-effects, particularly towards the end of life and that Mr A had been referred to the community palliative care team. We did not uphold the complaint.

Summary

Mr C complained about the dental treatment which his wife (Mrs A) received from her dentist. The dentist that examined Mrs A had said that there was decay in one of her teeth and that the existing crown should be removed; the decay treated; and a new crown fitted. An estimate was given for the potential costs of the treatment and/or crown, either on the NHS or as a private patient. Mrs A decided to take time to think about the matter and in the interim she increased her dental insurance cover should she have to pay a higher cost for the replacement crown. Mrs A then attended another dentist who said that there was no decay and that remedial work was not required. Mr C felt that the dentist was wrong to state that the tooth had decay and needed treatment, and as a result Mrs A had incurred extra costs.

We took independent advice from a dentist. We found that the dental treatment Mrs A received was reasonable and in line with accepted practice. Dental radiographs confirmed that there was decay in the tooth and that the existing crown did require to be removed to allow the decay to be treated. A new crown would then be required. We did not uphold the complaint.

Summary

Mrs C complained about the care and treatment which she received at the Royal Alexandra Hospital. She was in the hospital when her waters broke and there was a delay in transferring her to the labour ward. Mrs C underwent a caesarean section (surgical operation for delivering a child) and then went on to develop an infection which required antibiotics. Mrs C felt that the delay in transferring her to the labour ward was the cause of her infection.

We took independent advice from a consultant obstetrician (medical specialist in care of women before, during and after pregnancy) and gynaecologist (medical specialism in disorders of the female productive system) and found that Mrs C had received appropriate care and treatment. While there was a delay in transferring Mrs C to the labour ward, as it was busy at the time, Mrs C was kept under observation and there was no indication of problems with either her or her baby. Following the caesarean section Mrs C developed a temperature and appropriate blood tests were requested along with a medical review. Intravenous (into a vain) antibiotics (for possible infection) were started until the blood results were available. We did not uphold the complaint.

Summary

Mr C complained about the care and treatment his partner (Ms A) received from Glasgow Royal Infirmary for pain in her stomach. He said that the board failed to appropriately diagnose and treat Ms A's health issues within a reasonable time. Mr C's concerns included that for years, Ms A had been passed from one consultant at the hospital to another, without a diagnosis being made for her health condition and appropriate treatment being provided. He was also concerned that the board was now only offering Ms A treatment at the chronic pain clinic.

We obtained independent medical advice from a consultant gastroenterologist (specialism of treatment of the stomach and intestines). We found that Ms A's management had involved numerous specialities and, that all the referrals and the sequence of investigations appeared appropriate and consistent with the clinical guidance referred to in national guidance. We also found that Ms A's regular clinic reviews, and the explanations provided to her at these appointments, seemed appropriate. In terms of the care now being offered to Ms A, we considered that it was appropriate and reasonable. Therefore, we did not uphold the complaint.

Summary

Mr C complained that the board failed to appropriately assess and treat his chronic back pain. Mr C had received a recommendation for spinal cord stimulation (a pain management technique that involves the surgical implantation of an electrotherapeutic device onto the spinal cord) by a pain consultant from another area. The board explained to Mr C that they can only offer traditional spinal cord stimulation and not the high frequency type that was recommended for him as it was not available within Scotland. The board also said that Mr C did not meet the criteria for traditional spinal cord stimulation, which they do offer. In any case, any referral for further treatment would need to come from Mr C's local pain clinic which was not in Greater Glasgow and Clyde. Mr C was referred for a second opinion which confirmed agreement with the initial assessment and recommended a pain management programme. Mr C was dissatisfied with the board's decision and brought his complaint to us.

We took independent advice from a consultant in pain medicine. We confirmed that the treatment Mr C was seeking is not available in Scotland. We also confirmed it was correct to advise Mr C that any referral for further treatment would need to come from Mr C's local pain clinic. We concluded that the assessment of Mr C's pain was appropriate and the recommendation of a pain management programme was reasonable. Therefore, we did not uphold the complaint.