Not upheld, no recommendations

Summary

Miss C complained about the care and treatment she received at the Western General Hospital. Miss C had a history of breast cancer and at a routine examination a member of staff noticed some discolouration of the skin around the breast. Miss C was told by staff that they felt she may have dermatitis (a skin condition) and an urgent referral was made to the dermatology department (the  branch of medicine concerned with the diagnosis and treatment of skin disorders). Miss C was subsequently told that she had angiosarcoma (cancer of the inner lining of blood vessels, commonly found in the skin, breast, liver, spleen and deep tissue). Miss C felt that it was unreasonable that staff had thought she had dermatitis and by referring her to dermatology there was a delay in the treatment of her returning breast cancer.

We took independent advice from a medical adviser. We found that Miss C's original breast cancer had not returned and that she had developed a rare but recognised complication of breast cancer treatment, angiosarcoma. In its early stages, this can often look like dermatitis or bruising. We found that staff acted appropriately by arranging an urgent dermatology review with investigations which resulted in the correct diagnosis. There was no evidence of any undue delay in the diagnosis. Therefore, we did not uphold Miss C's complaint.

Summary

Ms C, an advocacy and support worker, complained on behalf of her client (Mr  A) about the care and treatment for knee pain Mr A received at Raigmore Hospital. Mr A had been assessed by a physiotherapist (a person qualified to treat disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise) but they did not arrange an x-ray or CT scan. Mr A's GP continued to prescribe pain relief, but as there was no improvement he sought a private opinion. The private opinion included a CT scan of the knee which identified that Mr A would require surgery for a torn cartilage. Mr A complained that there had been a delay in his treatment by the failure of the physiotherapist to arrange a CT scan of his knee.

We took independent advice from a physiotherapist. We found that the physiotherapist had taken an appropriate medical history from Mr A and an appropriate examination which resulted in a reasonable diagnosis of degenerative damage to the knee cartilage with a treatment plan of rehabilitation. There was no clinical requirement to arrange a CT scan at that time. Although it was subsequently established that Mr A had suffered an acute cartilage injury rather than by normal wear and tear, the treatment by rehabilitation can be used for either. Therefore, did not uphold Ms C's complaint.

Summary

Mr C complained about the practice's management of his son (Mr A)'s medication.

We took independent advice from a GP. We found that Mr A's medication was managed in a reasonable manner and did not uphold Mr C's complaint.

Summary

Mr C complained on behalf of his son (Mr A) about the mental health care and treatment provided by the board. Mr C complained that there had been a failure to provide support from a community psychiatric nurse, a delay in referral, and a failure to provide the necessary crisis support.

We took independent advice from a psychiatrist (a medical practitioner who specialises in the diagnosis and treatment of mental illness). We found that the mental health care and treatment provided to Mr A had been timely, supportive, and in line with Mr A's needs and wishes. We did not uphold this aspect of Mr  C's complaint.

Mr C also complained about the board's complaint response. We found that whilst the board gave limited information in response to one of Mr C's questions, this was in relation to care provided by another organisation. Therefore, we did not consider this unreasonable and we did not uphold this aspect of Mr C's complaint.

Summary

Mrs C complained that the board unreasonably communicated with her about the care of her mother (Mrs A). Mrs C was named as Mrs A's next of kin and had been listed as Power of Attorney, although this was not invoked for the majority of the period complained about.

We took independent advice from a social worker. We found that the records indicated Mrs C was involved regularly and kept up to date by the care home, which would be normal practice given the care home was responsible for the day- to-day care of Mrs A. We considered that the communication with Mrs C was reasonable and did not uphold the complaint.

Summary

Mrs C complained about the care and treatment that her late husband (Mr A) received at Glasgow Royal Infirmary. Mr A had cancer and was seen at clinic and placed on the waiting list for surgery. However, Mr A began to rapidly lose weight and Mrs C tried to contact the consultant for advice. Mr A was referred for a dietetic assessment and was advised to take nutritional supplements. Mr A was still unable to stop the weight loss and Mrs C again tried to contact the consultant for advice. The consultant was not available and arrangements were made for Mr A to see another consultant at short notice. It was then discovered that Mr A's condition had deteriorated and that surgery was no longer an option. Mrs C felt that action should have been taken sooner to reassess Mr A and that a scan should have been arranged at the clinic appointment.

We took independent advice from a consultant colorectal surgeon (a surgeon who specialises in conditions in the colon, rectum or anus). We found that there was no indication that a scan was required at the clinic appointment as a diagnosis had already been reached and Mr C did not report any new symptoms. It was appropriate that Mr A was then directed to a dietetic review in order to treat his poor nutritional intake so that he would be in appropriate health to undergo the planned surgery. There was no indication that a hospital admission was required at the time of the dietetic review. When Mr A saw another consultant, appropriate investigations were carried out although by that stage it was felt that he was no longer fit for the planned surgery. We did not uphold Mrs C's complaint. However, we did note that there was a failing in the passing of information from the secretarial staff to the clinical staff. This would not have affected the outcome and the board have already taken action to ensure that when clinicians are not available the matter should be escalated to another clinician.

Summary

Mrs C complained about the treatment she received from the orthopaedic service (the service which deals with issues of the musculoskeletal system) at Glasgow Royal Infirmary. She had been referred there by her GP for a suspected torn cartilage. She said that the consultant reviewed her and suggested that she have a hip injection, arranged for her to have a scan and said that the matter would be reviewed. Mrs C then saw another doctor who suggested an alternative treatment plan. Mrs C felt that it was unreasonable that the consultant did not take any further action at the initial appointment.

We took independent advice from an orthopaedic consultant. We found that the consultant had carried out a reasonable assessment in view of Mrs C's reported symptoms and medical history, and that it was reasonable to suggest that she had a hip injection. The fact that another clinician arrived at a different diagnosis was also reasonable in the circumstances. We did not uphold the complaint.

Summary

Mrs C complained that, despite attending the dentist over the years with tooth pain, the cause of her pain was not identified or treated appropriately. She was ultimately referred to a periodontal (gum) specialist. Mrs C complained that she had not been informed of the presence of gum disease, and that she had to wait several months for this specialist assessment and treatment. Mrs C felt that the lack of earlier treatment had placed her dental bridgework at increased risk.

We took independent advice from a dentist. We found that Mrs C's dental records confirmed discussions having taken place with Mrs C regarding her gum disease. We noted that Mrs C's gum health had deteriorated rapidly at the time she was referred to the periodontal specialist, and we considered this referral was appropriate. We considered that the actions of the dentist were appropriate and did not contribute to the increased risk of Mrs C losing her dental bridge. Therefore, we did not uphold Mrs C's complaint.

Summary

Mrs C attended the dentist for restorative crowning treatment of one of her teeth, having recently completed a course of private orthodontic treatment. Following completion of the crown preparatory work, Mrs C complained that her retainer felt slack and that there was subsequent movement in one of her teeth between then and her re-attending for the crown fitting a week later. The dentist considered that the movement was an orthodontic relapse issue and did not accept liability for the cost of the remedial orthodontic work required. Mrs C complained that there had been no movement prior to the crown preparatory work and that the movement could, therefore, only be attributed to this work.

We took independent dental advice from a general dental practitioner. We found that the treatment provided by the dentist was carried out appropriately and that this could not reasonably be responsible for the movement of Mrs C's tooth. We noted that any movement was likely to have occurred over a period of months, due to orthodontic relapse, rather than the short period of time between the crown preparation and crown fit appointments. We observed that the dentist's notes from an earlier appointment suggested that the tooth in question was not in a stable position and that relapse had already occurred. Therefore, we did not uphold Mrs C's complaint.

Summary

Mr C complained about the care and treatment he had received at Dr Gray's Hospital. Mr C, who had a history of heart problems, had attended a consultation at the cardiology unit (the branch of medicine that deals with diseases and abnormalities of the heart) where investigations were carried out and he was told there was no cause for concern. However, Mr C suffered a heart attack three months later and had to be fitted with a stent (tube inserted in a blocked artery to keep it open). Mr C felt that the previous investigations must have shown that he was at risk of a heart attack and that preventative action should have been taken.

We took independent advice from a cardiac consultant. We found that the previous investigations were appropriately carried out and reported on and it was reasonable for the clinicians to have diagnosed that Mr C had mild and stable angina (chest pain). The clinicians involved could not have predicted that Mr C would go on to suffer a heart attack after such a short period of time. We did not uphold the complaint.