Not upheld, no recommendations

Summary

Ms C complained that NHS 24 failed to provide her with an appropriate assessment of her condition and advice during a telephone call.

We took independent advice from a GP. We found that the questions asked by NHS 24 to assess Ms C's condition were reasonable and that there was no clinical indication for Ms C to be advised to attend A&E. We also noted that Ms  C was advised to see a pharmacist. We found that, ideally, Ms C should have been referred directly to the out-of-hours service, but it was not unreasonable or unsafe for Ms C to be advised to see a pharmacist. We did not uphold Ms C's complaint.

Summary

Mrs C complained that the board unreasonably delayed in diagnosing secondary breast cancer. Following treatment for breast cancer, Mrs C underwent annual check-ups with a consultant surgeon where she complained of a lump and pain near her reconstructed breast (a breast that has been reshaped following a mastectomy (breast removal)). Mrs C said that these reports were not appropriately investigated.

We took independent advice from a specialist in breast cancer. We found that investigations were carried out when Mrs C first reported a lump near the reconstruction and that relevant guidelines did not recommend routine mammography (x-ray of the breast) of the reconstructed site and associated axilla (underarm). We considered that the board had practised within the national recommendations and Mrs C was followed up and examined regularly. We also found that when Mrs C presented with a new lump it was investigated and treated in a timely manner. We found that the standard of medical care was reasonable and there had not been an unreasonable delay in diagnosing the recurring cancer. We did not uphold the complaint.

Summary

Ms C complained that the board's response to her complaint was unreasonable and contained many errors.

We found that the board's response was an accurate reflection of their records of Ms C's treatment. The board explained why they could not delete entries from Ms C's medical records, and added Ms C's handwritten note to the records to reflect her view of events.

The board acknowledged that they could have provided Ms C with better information and support to make informed choices about ongoing treatment, and said they were sorry for this. Ms C chose to get private treatment as she was unhappy with the treatment she had received from the board and wanted the board to pay for this. The board offered Ms C different treatment options and consultations with different doctors but Ms C declined this offer. The board's response explained why, under the circumstances, they could not pay for Ms C's private treatment.

We considered that the board's response to Ms C was reasonable. Therefore, we did not uphold the complaint.

Summary

Mr C complained about the care provided to his wife (Ms A) during a home birth, in particular that two midwives did not attend at the same time.

We took independent advice from a midwife. We found that it was standard practice for one midwife to attend first and that the role of the second midwife is to assist in the event of an emergency requiring one-to-one care. We considered that there was no requirement for emergency care for either Ms A or their child, and therefore, no requirement for a second midwife to be present. We did not uphold this aspect of Mr C's complaint.

In the days after the birth, community midwives attended Mr C's home and following an incident, the board decided not to allow any further visits to Mr C's home if he was present. Mr C complained that this decision was unreasonable.

We found that the board's actions had been appropriate and the decision taken was reasonable based on the available information. Therefore, we did not uphold this aspect of Mr C's complaint. However, we considered that a further risk assessment should be undertaken in the event of any future pregnancies, to review the requirement for the restriction to remain in place, and we fed this back to the board.

Summary

Mr C complained about the treatment he received at Glasgow Royal Infirmary. He had attended as a day case for an Endoscopic Ultrasound Scan (EUS, a minimally invasive procedure to assess digestive and lung diseases) where a biopsy was taken. On the way home after the procedure Mr C became unwell and was taken to another hospital where he was diagnosed with acute pancreatitis (inflammation of the pancreas). He was admitted for treatment and further deteriorated, and it was found he had ruptured his spleen which then had to be removed. Mr C felt that the EUS had not been carried out appropriately and that it had caused his health problems.

We took independent medical advice from a consultant surgeon. We found that the EUS had been performed appropriately but unfortunately Mr C had developed pancreatitis which is a rare but recognised complication of the procedure and there was no evidence of any failings during the procedure. Similarly, Mr C then developed a further rare complication of pancreatitis where his spleen ruptured which is usually as a result of infection or severe inflammation. We did not uphold the complaint.

Summary

Ms C complained about the care and treatment she received from the practice regarding a flu vaccination and that the practice did not provide her with an appointment when she called them. Ms C was subsequently diagnosed with Idiopathic Thrombocytopenic Purpura (ITP, a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets (the cells that help blood clot)) which she considered was linked to the flu vaccination she received.

We took independent advice from a GP. We found that the care and treatment Ms C received was reasonable and that she was not informed about the risk of ITP because it is not a recognised side effect of the flu vaccination.

We also found that there was no record of Ms C's call to the practice to book an appointment. We considered that it was reasonable that there was no record of this call in Ms C's medical record. In the circumstances we did not have sufficient evidence to determine whether Ms C should have been offered an appointment or that the care provided by the GP Practice was unreasonable.

We did not uphold Ms C's complaints.

Summary

Mrs C complained that the practice failed to provide her late aunt (Ms A) with appropriate care and treatment. Ms A visited the practice on three occasions and was later admitted to hospital where she was diagnosed with septicaemia (blood poisoning), multi-organ failure and metastatic gastric (stomach) cancer. Mrs C complained that the practice failed to reasonably investigate Ms A's symptoms. Mrs C also complained that the practice failed to respond to her complaint in a reasonable way.

The practice acknowledged that there were shortcomings in record-keeping and checking observations. The practice apologised and took action to address these issues.

We took independent advice from an adviser in general practice medicine. We found that the investigation and treatment decisions provided to Ms A at each of the three consultations were of a reasonable standard and that an emergency admission to hospital by ambulance was not required given the circumstances. We considered that the standard of medical care and treatment provided to Ms A was reasonable. We also found that the practice responded to Mrs C's complaint in a reasonable way. Therefore, we did not uphold Mrs C's complaints.

Summary

Mrs C complained about the medical care and treatment her late mother (Mrs A) received when she attended the emergency department at Queen Elizabeth University Hospital. Mrs C said that no blood or blood gases tests were carried out before Mrs A was discharged.

We took independent advice from a consultant in emergency medicine. We found that there had been no indication to carry out blood or blood gases tests when Mrs A had attended the emergency department and that the care and treatment she received had been reasonable. Therefore, we did not uphold the complaint.

Summary

Having been diagnosed with lung cancer, Mrs C complained that she had been attending the practice for years with breathlessness and she considered that she should have been referred for specialist investigation sooner. The practice noted that Mrs C was fully investigated for intermittent complaints of breathlessness, and that she was diagnosed with chronic obstructive pulmonary disease (COPD - a disease of the lungs in which the airways become narrowed). The practice said that when Mrs C presented with new symptoms (a nocturnal cough along with worsening breathlessness) she was promptly investigated and the diagnosis of lung cancer was made. They did not consider there were previously any suggestive symptoms that might have prompted an earlier referral for suspicion of cancer. They noted that the grading of the cancer indicated it had been detected relatively early, and they considered that her COPD was the more likely source of her breathlessness.

We took independent advice from a GP. We found that it was reasonable for the practice to have made a presumptive diagnosis of COPD and that they sought to manage this within the primary care setting. The adviser said that the practice could have considered requesting a chest x-ray and respiratory referral around ten months earlier than they did, as Mrs C had reported worsening breathlessness (not just on exertion but also at rest). However, the adviser did not consider it unreasonable for them not to have taken that approach. They noted Mrs C was referred for breathing tests at that time, which confirmed the COPD diagnosis. On balance, we did not uphold the complaint.

Summary

Mr C complained about the care and treatment he received from the ear, nose and throat (ENT) service at Inverclyde Royal Hospital. Specifically, that he was not examined thoroughly and that staff were dismissive of his symptoms being related to sinusitis (inflammation of the lining of the sinuses).

We took independent advice from a consultant ENT surgeon experienced in treating cases requiring sinus surgery. We found that Mr C's symptoms had been appropriately investigated, in particular with CT scans (a scan that uses x-rays and a computer to create detailed images of the inside of the body) and endoscopy (direct visualisation by camera). There was no evidence to show that Mr C had bacterial or fungal sinusitis or any evidence of a sinus tumour. We considered that Mr C's care and treatment was reasonable and appropriate and did not uphold his complaint.