Not upheld, no recommendations

Summary

Mr C complained on behalf of his mother (Ms A) about the partnership's decision to discharge Ms A from hospital based care and into a care home.

We took independent medical advice. We found that the partnership had followed Scottish Government guidance in both reaching their decision, and in processing Mr C's appeal of that decision. We did not uphold the complaint.

Summary

Mrs C complained about the treatment which she received at Ninewells Hospital. Mrs C had been receiving iloprost infusions (intravenous medication) for a number of years for her medical conditions which included Raynaud's disease (numbness in fingers or toes). However, the board had changed the criteria for iloprost infusions and advised Mrs C that the infusions would stop. Mrs C felt that this was unfair as the treatment had provided her with relief from her symptoms.

We took independent advice from a consultant physician and rheumatologist (a doctor who specialises in the diagnosis and treatment of rheumatism, arthritis, and other disorders of the joints, muscles, and ligaments). We found that the criteria followed by the board in relation to iloprost infusions was reasonable and that while Mrs C may have benefitted from the treatment, there was no clinical evidence that this was the case. We also found that the board had offered to refer Mrs C to another health board who would offer the treatment as a temporary measure. The board also suggested reasonable alternative treatment options and were continuing to do so. Therefore, we did not uphold the complaint.

Summary

Ms C complained to us about the care and treatment her son (Mr A) had received at Ninewells Hospital. Mr A was admitted to the Intensive Care Unit (ICU) with pneumonia (an infection of the lungs) and died within a month of his admission. In particular, Ms C complained that there was a delay in referring Mr A for surgery to treat his pneumonia.

We took independent advice from a consultant in intensive care medicine. We found that there were no failings in the management of Mr A's pneumonia and that his treatment was reasonable and appropriate.

Ms C also complained that Mr A was kept awake during his time in the ICU, even though he had mental health issues and he was experiencing alcohol and nicotine withdrawal. We found that Mr A's level of sedation was assessed appropriately on a daily basis and that he was given a combination of sedative medication that was appropriate for his individual needs. However, we found that in future, the board may wish to consider the use of nicotine patches for patients withdrawing from nicotine.

Ms C raised concerns that there were delays in treating Mr A's diarrhoea. We found that he was appropriately investigated for any underlying infection and in the meantime, his diarrhoea was managed appropriately through the use of a flexiseal device (a bowel movement management device).

We considered that the care and treatment Mr A received was reasonable and did not uphold Ms C's complaint.

Summary

Mr C, an MSP, complained on behalf of his constituent (Mrs A) about the decision taken by the board not to offer Mrs A surgery to her wrist. Mr C said that the board had not reached the decision based on full information.

We took independent advice from a consultant plastic and hand surgeon (a surgeon who repairs or reconstructs missing or damaged tissue and skin). We found that the decision not to offer surgery was reasonable and had been made by a number of experienced surgeons together in a mutlidisciplinary setting. Therefore, we did not uphold the complaint.

Summary

Mrs C complained about the care and treatment given to her elderly mother (Mrs  A) by both the out-of-hours (OOH) service and the Emergency Department (ED) of the Queen Elizabeth University Hospital. She said that Mrs A called the OOH service early in the morning as she feared she had sepsis (a blood infection). A GP attended and decided that she could remain at home. Mrs C believed that Mrs A should have been admitted to hospital. Later the same day, Mrs C took Mrs A to the ED as she said that she was experiencing rigours (episodes of shaking). She was later discharged. Mrs C said that Mrs A had to return to hospital within the week, when she was diagnosed as having sepsis.

We took independent advice from a GP and from a consultant in emergency medicine. We found that both at home and in hospital, Mrs A had been treated reasonably. The GP initially examining her had found her temperature, pulse rate, oxygen saturation and blood pressure all to be in the normal range. She had no 'red flags' in terms of the guidance and she was given clear advice about what to do if her condition worsened. When Mrs A attended the ED, all the tests undertaken were normal and did not indicate further screening. As Mrs C was unhappy with this, further examination was made, but again this did not indicate admission or screening for sepsis. While Mrs C said that Mrs A went on to develop sepsis within a few days, we found that this was not unusual. We did not uphold the complaints.

Summary

Mr C complained about the treatment which he received at Aberdeen Royal Infirmary. He had attended for a regional anaesthetic (nerve block) procedure. During the procedure he suffered a reaction and became unwell with severe breathing difficulties and had to undergo Cardiopulmonary Respiration (CPR) (medical procedure for a patient in cardiac arrest). Mr C wondered if the nerve block procedure had been carried out correctly.

We took independent advice from a consultant anaesthetist and found that the nerve block procedure was performed to an appropriate standard but unfortunately Mr C had an adverse reaction, possibly due to a combination of factors. When it became evident that Mr C was experiencing problems, staff appropriately carried out CPR as a precaution. We did not uphold the complaint.

Summary

Mr C has a complex medical history and made a number of complaints to the board. Mr C complained that the board failed to adequately address repeated errors in the provisions of prescription drugs, failed to inform the prison service of the requirements of his care plan and allowed his medical records to be altered retrospectively. Mr C also complained about the board's handling of his complaint.

We took independent advice from an adviser specialising in general medicine. We found that, on occasion, there had been delays in the provision of prescription drugs. However, these delays did not have a significant impact and it was not unreasonable for the dispensation of medicine to be subject to prison procedures, which limited the hours when medication could be issued. We did not uphold this aspect of Mr C's complaint.

In relation to Mr C's care plan, we found that it had been reviewed and he had been able to participate in those meetings along with prison service staff. We considered that the board communicated reasonably and appropriately with the prison service. We did not uphold this aspect of Mr C's complaint.

In relation to Mr C's medical records, we found that the board said it was impossible to amend records retrospectively. The adviser noted that this statement was inaccurate and we provided feedback to the board in light of this. However, we found no evidence that Mr C's medical records had been altered retrospectively and did not uphold this aspect of Mr C's complaint.

Finally, we found that Mr C had received an explanation from the board for the way his complaint was handled and an apology for any confusion caused. We considered this approach to be reasonable and did not uphold this aspect of Mr  C's complaint.

Summary

Mrs C complained about the care provided to her late husband (Mr A) by the practice. Mr A who suffered from chronic obstructive pulmonary disease (COPD, a disease of the lungs in which the airways become narrowed) attended the practice on a number of occasions reporting breathing problems but felt that the doctors did not listen to him. Mr A was later admitted to hospital with pneumonia (an infection of the lungs) where he suffered a heart attack and died. Mrs C complained that the practice failed to provide Mr A with appropriate treatment in view of his symptoms.

We took independent medical advice from a GP. We found that the practice had carried out thorough investigations into the symptoms reported by Mr A and that his COPD did result in him having breathing issues. We also found that the practice prescribed appropriate antibiotics but that Mr A's condition and symptoms were drastically different between his final two consultations and it was only at that time that a hospital admission was required. Therefore, we did not uphold the complaint.

Summary

Mr C complained about the clinical treatment which he received when he attended Borders General Hospital for treatment for a shoulder injury. He felt he had been seen by staff who were not qualified to treat his injury and that there had been a delay in seeking a surgical option for the injury. He also complained that the x-rays taken were of poor quality and that this had contributed to his delayed recovery.

We took independent advice from a consultant in orthopaedics (a specialist in the treatment of diseases and injuries of the musculoskeletal system). We found that Mr C had sustained a type of shoulder fracture and that these fractures are treated conservatively, without the need for surgery. Mr C's shoulder injury was initially treated by placing in a collar and cuff sling, and he was seen for follow-ups at clinics. Mr C then developed a mal union (where the bones do not heal up straight) and a stiff shoulder, which are recognised complications of the injury which Mr C had sustained. We also found that Mr C had been seen by appropriately qualified clinicians and allied health professionals and that the x- rays which were taken were of a sufficient quality. We did not uphold Mr C's complaint.

Summary

Mr C complained that a sewer located behind his property routinely flooded, damaging his garden. Mr C said that Scottish Water had not taken reasonable steps to fix this and that they had not responded properly to his complaints.

Scottish Water said that they had responded to all the incidents of flooding but the problem was more widespread than Mr C's property and it had taken considerable investigation to identify the cause and possible solutions. Scottish Water also said that they had provided increasing levels of support to Mr C as the severity of the problem became apparent.

We found that Scottish Water had acted reasonably in investigating the flooding incidents and supporting Mr C. They had carried out extensive works to repair any damage and they had increased the level of support to Mr C as the complexity of the problem became apparent.

In relation to complaint handling, we found that Scottish Water should have referred Mr C to the complaints process earlier than they did. However, it was clear that Scottish Water had taken steps to improve their responses to him and the way they handled complaints. Therefore, we did not uphold either of Mr C's complaints.