Not upheld, no recommendations

Summary

Miss C complained about the treatment which her late child (Child A) received at Wishaw General Hospital. Child A had recently had a vaccination and had developed a temperature and a rash. Miss C asked the staff if Child A could have Kawasaki Disease (heart disease) and was told that they did not meet the criteria. Instead Child A was treated for a viral infection and then discharged home after a period of observation. Although Child A showed some signs of improvement, over two weeks later they were admitted to hospital where they died. The post mortem report showed findings in keeping with Kawasaki Disease. Miss C felt that staff should have carried out additional investigations when Child A was originally at the hospital and the disease would have been identified sooner.

We took independent advice from a consultant paediatrician. We found that the staff carried out appropriate assessments when Child A attended the hospital and that it was reasonable to have arrived at a working diagnosis of viral infection based on their reported symptoms. Child A did not meet the criteria for Kawasaki Disease at that time and there was no clinical indication that a hospital admission or referral to other hospital specialist was required. We did not uphold Miss C's complaint.

Summary

Mrs C complained about the care which she received from the practice. She said that the practice unreasonably refused to prescribe her pethidine (painkiller) medication and removed it from her list of repeat medications. Mrs C said that she had been on the medication for a number of years and that no alternative painkillers were prescribed and she was at risk of withdrawal symptoms.

We took independent advice from a GP. We found that the clinical records indicated that Mrs C had agreed to stop pethidine, she had also said it was her intention to try ibuprofen (anti-inflammatory pain relief medication) and that she still had a stock of pethidine at home. We found that the GP correctly did not prescribe additional painkilling medication in the meantime and also that Mrs C had not been taking pethidine on a regular basis and as such it was unlikely she would have suffered from withdrawal symptoms. Therefore, we did not uphold Mrs C's complaint.

Summary

Miss C complained about the antenatal care she received from the community midwifery team when she was pregnant. Miss C was informed she was on the "red pathway care" for her pregnancy which meant her antenatal care would be led by a consultant obstetrician (a doctor who specialises in pregnancy and childbirth) and supported by the community midwifery team.

Miss C complained that she was told by her midwife at her first appointment that she would not need to have future appointments with her midwife and would only see her consultant. Miss C also complained that she missed out on vital check ups and she did not receive her relevant maternity forms on time. The board apologised that the consultant did not provide Miss C with the appropriate forms.

We took independent advice from a midwife. We found that when Miss C contacted the community midwifery team, the midwife acted appropriately and offered to meet with Miss C to provide her with the necessary forms and information, however, Miss C refused this offer and did not engage in the service. We found at this point, Miss C was still within the required timescale for submitting her forms, therefore, she did not suffer any significant injustice as a result. We did not find any evidence that Miss C was advised at her first appointment that she was not required to see her midwife again. We did not uphold Miss C's complaint.

Summary

Ms C has complex Post-Traumatic Stress Disorder (a psychological disorder that can develop in response to prolonged, repeated experience of interpersonal trauma) and had been receiving Comprehensive Resource Model (CRM - a holistic therapeutic approach to help people re-process and release the effects of traumatic events) treatment under the care of her psychiatrist. Ms C heard that her psychiatrist had left the practice and that she was to be offered a six week course of Cognitive Behavioural Therapy (CBT - a talking therapy aiming to help manage problems by changing the way people think and behave) in place of CRM treatment. Ms C had tried this before and found it of little benefit. Ms C complained that the board had failed to consult her on the decision to withdraw CRM treatment, and had failed to put in place an appropriate support plan for her.

The board explained that the removal of this treatment was a result of a review of all adult psychiatry services, stating that there was no evidence base for CRM and it did not appear on the Matrix for Psychotherapy Treatments (a guide to planning and delivering evidence-based psychological therapies within NHS boards in Scotland).

We took independent advice from a consultant psychiatrist. We found that Ms C had been discharged from the service on clinical grounds and would only have been informed of the decision to withdraw the treatment when she requested a new appointment. We were satisfied that the board did not have a specific duty to consult with Ms C before deciding to withdraw from providing CRM treatment and we, therefore, did not uphold this complaint.

In relation to the support plan put in place following the board's decision to withdraw CRM treatment, the board said that the psychiatrist had wanted to find out the wishes of their patients in care provision. They had discussed the future care of all their patients and had agreed to refer them to their Community Health Team for an assessment of their needs. We found that the board's approach in offering individual appointments to assess ongoing needs for future treatment was reasonable. Therefore, we did not uphold this complaint. However, we did find shortcomings in the board's communication with Ms C in relation to the matters she complained about and fed this back to the board.

Summary

Mrs C made a complaint on behalf of Mrs B about the care and treatment her late husband (Mr A) received at his GP practice. Mr A had a number of health issues including epilepsy for which he had been prescribed medication for many years. Mr A had attended the surgery for worsening upper abdominal pain following a two day history of vomiting. Mr A was admitted to hospital where he died several days later. Pancreatitis (inflammation of the pancreas) was recorded as one of the causes of Mr A's death. Mrs C complained that the practice had failed to provide Mr A with reasonable care and treatment. In particular, that Mr A's GP had failed to recognise that Mr A's epilepsy medication could cause pancreatitis.

We took independent advice from a GP. We found that the care and treatment provided to Mr A by the practice was reasonable. Mr A's health concerns were appropriately investigated and blood tests and referrals were made as appropriate and in a timely manner. We also noted that pancreatitis is a very rare side effect of the medication Mr A was taking for his epilepsy. We considered that the care provided to Mr A by the practice was of a reasonable standard and in line with good medical practice. Therefore, we did not uphold Mrs C's complaint.

Summary

Ms C, an advice worker, complained on behalf of her client (Mr A) about the care provided to him by the practice. Mr A had repeatedly reported his concerns about stomach problems and when he was referred to hospital specialists they diagnosed that he had a stomach ulcer. Mr A felt that there was a delay in referring him to the hospital specialists.

We took independent medical advice from a GP. We found that the practice had appropriately assessed Mr A's reported stomach problems over a period of years, provided appropriate medication and referred Mr A to hospital specialists when his symptoms failed to resolve. There was no delay in the referral to the hospital specialists, and while initially the hospital specialists had diagnosed a stomach ulcer, there were also thoughts that Mr A's symptoms were related to his other health conditions. We did not uphold the complaint.

Summary

Miss C complained about the care and treatment her late father (Mr A) had received in Glasgow Royal Infirmary before his death. Mr A had previously been diagnosed with lung cancer, which had been treated with radiotherapy (a  treatment using high-energy radiation). He also had moderate chronic obstructive pulmonary disease (a disease of the lungs in which the airways become narrowed), peripheral vascular disease (a common condition, in which a build-up of fatty deposits in the arteries restricts blood supply to the leg muscles) and severe heart disease. After his admission to the hospital, Mr A's condition deteriorated over the next week and staff decided that he was not fit enough to undergo further radiotherapy. Mr A died just over a week after being admitted to hospital.

We took independent advice from a consultant in acute medicine. We found that there had not been any failings in Mr A's care and treatment. His oxygen levels had been monitored appropriately and the action taken to diagnose and treat his chest infection were reasonable. It had also been reasonable to give Mr A morphine (pain relief) and to discuss end of life care with him. We did not, therefore, uphold Miss C's complaint.

Summary

Mrs C complained about the care and treatment her late husband (Mr A) received from the board's out-of-hours emergency care centre and during his time as an in-patient at Aberdeen Royal Infirmary. In particular, Mrs C was dissatisfied that the out-of-hours service did not admit Mr A to hospital at the time and that after he was admitted around a week later, he died following a head scan.

We took independent advice from a general practitioner in relation to the out-of-hours care and treatment. We found that an appropriate medical history was taken and an appropriate examination performed. We considered that it was not necessary to repeat blood tests that had been done at Mr A's GP practice which were found to be abnormal. We found that the out-of-hours service's decision not to admit Mr A to hospital was in keeping with national guidelines on the treatment of community acquired pneumonia (an infection of the lungs) and that appropriate antibiotic treatment was prescribed with follow-up review advised. Therefore, we considered that the out-of-hours care was reasonable and we did not uphold this aspect of Mrs C's complaint.

In terms of the hospital care and treatment, we took independent advice from a consultant in general medicine. We considered overall that there was evidence to show that the severity of Mr A's illness was recognised and responded to appropriately. We found that it was reasonable to perform a head scan given Mr  A's increasing confusion and there was evidence to show that his clinical observations (temperature, pulse, blood pressure and breathing rate) were stable before it was carried out. We found that there was evidence to support that communication took place with Mrs C and the family regarding Mr A's deteriorating condition and the possibility that he might not survive. We did not uphold this aspect of Mrs C's complaint but provided feedback to the board about checking a families understanding of information given to them.

Summary

Miss C, an advice worker, complained on behalf of her client (Mr B) regarding the care and treatment of his late wife (Mrs A). Mrs A had been admitted to Forth Valley Royal Hospital for treatment for influenza and was discharged back to her care home with medication. Mrs A had to be readmitted after five days where she was treated for pneumonia (a lung infection). Mrs A did not respond to further treatment and died in the hospital. Mr B felt that Mrs A should not have been discharged from the hospital initially and that staff had reached a wrong diagnosis.

We took independent advice from a consultant in medicine and found that Mrs A had received appropriate treatment during the hospital admissions. In the first admission, her symptoms were appropriately diagnosed as being influenza related and she received appropriate investigations and treatment and was discharged when her symptoms improved. Mrs A was then readmitted with different symptoms suggestive of further or a new chest infection. We did not uphold Miss C's complaint.

Summary

Mr C complained on behalf of his wife (Mrs A). Mrs A was referred to the board by her dentist for a wisdom tooth extraction. After the procedure Mrs A experienced significant pain and other adverse symptoms. She was re-referred to the board by her dentist for further review, however, they did not identify any post-operative issues such as nerve damage, other than that the surgical site was healing slowly. Mr C complained that the dentist failed to provide thorough information about the risks associated with the wisdom tooth extraction, and that the procedure was not performed correctly.

We took independent dental advice. We found that the information and advice provided to Mrs A was clear and in line with national guidance. We also found there was no evidence to suggest the procedure was not performed correctly. We did not uphold Mr C's complaints.