Not upheld, no recommendations

Summary

Mrs C, an advice and support worker, complained on behalf of her client (Mrs A) regarding the treatment she received from the domiciliary podiatry service (area of medicine that treats disorders of the foot, ankle and lower limb). Mrs A complained that the podiatrists failed to review her on a regular basis and that they did not appropriately treat her foot blisters, cuts or check her foot pulses.

We took independent advice from a podiatry manager. We found that the records indicated that the podiatrists reviewed Mrs A on a regular basis based on her presenting symptoms. When she requested an emergency appointment this was arranged within an appropriate timescale. We found that the podiatrists provided appropriate treatment in view of Mrs A's presenting symptoms and that her foot pulses were checked on an annual basis in line with national guidance. We did not uphold Mrs C's complaint.

Summary

Ms C complained that the treatment she received at Dumfries and Galloway Royal Infirmary was unreasonable. Ms C underwent a small bowel resection (removal of part of the small intestine) and since then had experienced significant pain. Ms C said that the treatment options were restricted for her and that her symptoms were being ignored.

We took independent advice from a colorectal and general surgeon (a surgeon who specialises in conditions in the colon, rectum or anus). We found that Ms  C's medical circumstances were very complex, and from the medical notes it was clear that treatment options were not straightforward and came with many risks. We found no evidence that appropriate treatment was withheld from Ms C. We also found that the medical care Ms C received was reasonable, appropriate investigations had been made and there was careful consideration of her care with appropriate discussions and follow-up appointments arranged for further treatment. Therefore, we did not uphold Ms C's complaint.

Summary

Ms C, an advocacy worker, complained on behalf of her client (Ms A) about the care and treatment provided by the board in relation to a respiratory (breathing) condition. Ms C complained that Ms A had been unreasonably discharged from the care of a lung specialist when the specialist left the board. She also raised concerns about the medical and nursing care provided when Ms A was admitted to Hairmyres Hospital. Finally, Ms C complained that the follow-up Ms A received at Monklands Hospital was unreasonable and that the board's response to the subsequent complaint was unreasonable.

We took independent advice from a respiratory consultant. We found that as Ms  A's condition was stable, it was reasonable to discharge her when the lung specialist left the board. The discharge letter provided advice to Ms A's GP that if her symptoms progressed, she should be re-referred as a new patient. We also found no failings in the medical care and treatment that Ms A received either as an in-patient or in follow-up as an out-patient. Therefore, we did not uphold these parts of Ms C's complaint.

We took independent advice from a nursing adviser in relation to Ms A's concerns about nursing staff. We found that the nursing care that was provided to Ms A was reasonable. We did not uphold this part of Ms C's complaint.

Finally, we found that the response to Ms A's complaint was reasonable and considered that it addressed the points listed in her original complaint. Therefore, we did not uphold this part of Ms C's complaint.

Summary

Ms C, an advocacy worker, submitted a complaint on behalf of her client (Ms A). Ms A was diagnosed with polycystic ovaries (a condition that affects a woman's hormone levels) after undergoing a laparoscopic (minimally invasive) surgery to untwist a torted right ovary. Further investigations were carried out, including two ultrasound scans. After experiencing severe lower abdominal pain, an emergency salping-oophorectomy (removal of the fallopian tube and ovary) was carried out. This took place two days after Ms A's second ultrasound. Ms C complained that the second ultrasound scan was not carried out appropriately and that an ultrasound scan should have taken place when she was admitted to hospital inbetween her two other scans.

We took independent advice from an obstetrics and gynaecology consultant (a  doctor who specialises in pregnancy, childbirth and the female reproductive system). We found that it was reasonable for the board to not carry out an ultrasound scan during Ms A's admission. We noted that Ms A's condition appeared to have been managed appropriately and conservatively, based on the information known at the time. We also found that an ovarian torsion can happen over a few hours and, therefore, it is possible that it had not occurred when the second ultrasound took place. We acknowledged that it was not possible to know for certain whether anything of concern was overlooked during this ultrasound, however, we considered that the board's management of Ms A's condition was reasonable and appropriate. We did not uphold either of Ms C's complaints.

Summary

Ms C injured her shoulder and attended the emergency department where she was assessed and referred to a fracture clinic. Following the appointment at the fracture clinic, it was decided the injury should be treated conservatively. At a further follow-up appointment, it was decided that Ms C should be referred for surgery. The local orthopaedic surgeon (a specialist in the treatment of diseases and injuries of the musculoskeletal system) was unavailable and it was agreed that Ms C should wait until a specialist orthopaedic surgeon was available. Ms C complained that the board unreasonably delayed in performing the surgery.

We took independent advice form an orthopaedic surgeon. We found that it was reasonable that the injury was treated conservatively in the first instance and that they waited until a specialist surgeon was available. Ms C's outcome would have been affected not by the delay, but if the surgery was not performed by a specialist. Therefore, we did not uphold Ms C's complaint.

Summary

Ms C complained about the decision not to provide her with a gastric pacemaker (a device that electrically stimulates the muscles that empty the stomach).

We took independent advice from a gastroenterologist (a doctor specialising in the treatment of conditions affecting the liver, intestine and pancreas). We found that the decision not to provide a gastric pacemaker was reasonable as Ms C's symptoms fluctuated, she had other health conditions impacting on her condition and there was limited evidence that the gastric pacemaker would benefit her condition. Therefore, we did not uphold Ms C's complaint.

Summary

Ms C, an advocate, complained on behalf of her client (Ms A) about the care and treatment Ms A received at Glasgow Royal Infirmary. Ms A broke her distal fibia (the end of the fibula bone, one of the bones that supports the ankle joint) and underwent surgery to repair the break. Ms C said that the plate was not fixed in the appropriate place, causing poor healing and requiring further surgery to fix the error.

We took independent advice from an orthopaedic surgeon (a specialist in the treatment of diseases and injuries of the musculoskeletal system). We found that Ms A's treatment was reasonable as the initial operation was carried out appropriately, with the plate and screws reasonably placed. Ms A was then reviewed in further clinics, with appropriate advice given to manage the healing process. There was evidence that the injury was not healing as expected and further investigations, including a CT scan were undertaken. This identified that Ms A had developed a recognised complication which led to the need for a further operation. We considered the treatment Ms A received to be reasonable and did not uphold Ms C's complaint.

Summary

Mr C complained about the care provided to his late mother (Mrs A) by the practice. In particular, Mr C said the practice knew that his mother had cancer and had had chemotherapy. However, the family had concerns that on one occasion there was a failure to admit Mrs A to hospital and, on another, a GP had refused to make a home visit. When Mrs A was seen by a different GP the same day, she was admitted to hospital. Mr C felt that given his mother's medical history, the practice could have provided more appropriate care.

We took independent medical advice from a GP. We found that the GPs involved in Mrs A's care carried out appropriate assessments given the reported symptoms. On the first occasion, the GP had contacted the oncology (cancer) specialists for advice as Mrs A was experiencing the side effects of chemotherapy. At that time, it would not have been appropriate to have referred Mrs A to hospital due to the increased risk of her catching an infection from other patients who may have been unwell or from hospital acquired infections. On the second occasion, there was a change in Mrs A's symptoms from when the initial request for a home visit was made. As a result a home visit was arranged and Mrs A was appropriately admitted to hospital at that time. Therefore, we did not uphold Mr C's complaint.

Summary

Ms C complained about the care and treatment her mother (Mrs A) received at the practice. Mrs A had a history of a number of health issues and Ms C said that the practice failed to monitor her properly or to ensure that she saw a cardiologist (a doctor who specialises in diseases and abnormalities of the heart). She further complained that Mrs A's symptoms were not treated reasonably and the medication she was prescribed was inappropriate.

We took independent advice from a GP. We found that Mrs A had been regularly seen, review appointments had been arranged and the medication prescribed was reasonable. At a previous surgery, Mrs A was managed in secondary care (in a hospital by a cardiologist) who had the responsibility for ensuring her ongoing cardiology follow-up and monitoring. We found that the practice had noted that Mrs A had not been to a follow-up and they contacted the hospital to advise them as was appropriate. Therefore, we did not uphold Ms C's complaint.

Summary

Mr C complained that he was not made aware of the risk of having a skin-sensitive test before it was performed and that the board failed to ensure the test was carried out in a reasonable way. Mr C suffered from urticaria (hives) and he underwent a Minimal Erythema Dose (MED, short exposure to ultraviolet radiation) test to help inform phototherapy (light) treatment for the condition. Mr  C said that after the test he was left with scarring on his lower back.

We took independent advice from a specialist in dermatology (the branch of medicine concerned with the diagnosis and treatment of skin disorders). We found that there was evidence that the treatment was confirmed to Mr C and the possible side-effects were explained to him. We also found that Mr C signed the form saying the treatment and side-effects had been explained to him. Therefore, we did not uphold this aspect of Mr C's complaint.

In relation to how the test was carried out, we found that Mr C experienced a normal darkening of his skin as a result of the process and this was temporary. We also found that there was no evidence to show the test was carried out in an unreasonable way. Therefore, we did not uphold this aspect of Mr C's complaint.