Not upheld, no recommendations

Summary

Miss C complained to us about the standard of dental treatment provided to her adult son (Mr A) by the dentist over a number of years. In particular, she raised concern that there were delays in referring Mr A to hospital for specialist treatment and that the dentist had failed to listen to her concerns that Mr A should have been provided with braces.

We took independent advice from an adviser in general dentistry. Whilst we did note some failings in record-keeping, we found that there was no delay in referring Mr A to hospital. We also found that there was no evidence that Mr A needed braces. We did not uphold the complaint, however, we highlighted our concerns about record-keeping to the dentist to use as a learning opportunity.

Summary

Ms C, who is an advocacy and support worker, complained on behalf of her client (Mr A) about the care and treatment Mr A had received at Raigmore Hospital. Mr A had been diagnosed with terminal cancer. Ms C complained that a consultant oncologist (a doctor who specialises in cancer treatment) unreasonably told Mr A that radiotherapy (a treatment using high-energy radiation) he had received for his cancer had not worked and that he should take pazopanib (a drug used to treat kidney cancer). Mr A considered that the radiotherapy had been effective and that he should be given further radiotherapy treatment.

We took independent advice from a consultant uro oncologist (a doctor who specialises in treating cancers of the urinary system and male reproduction system). We found that it had been reasonable for the board to consider that the radiotherapy had not been effective and that Mr A should take pazopanib. We found that there had not been any failings in Mr A’s management by the board. His decision not to take pazopanib was also respected by the clinicians and he was given further radiotherapy. We did not uphold Ms C's complaint.

Summary

Ms C complained that the physiotherapy treatment she had received at Lorn and Islands Hospital had been unreasonable, inappropriate and had caused her injury.

We took independent advice from a physiotherapist. We found that there was no evidence that the assessment or physiotherapy treatment Ms C received had been unreasonable or inappropriate. Ms C had given consent to all of the treatments she received. We were also satisfied that the board had tried to address her concerns and to explain the reasons for the treatment she had received. In addition, they had produced an information leaflet for patients about the nature and range of treatment options available. Therefore, we did not uphold Ms C’s complaint.

Summary

Ms C complained about the care and treatment provided to her late partner (Mr A) during his time as an in-patient at New Craigs Psychiatric Hospital and after his discharge. Ms C was concerned that the potential physical causes of Mr A's psychosis (a mental health problem that causes people to perceive or interpret things differently from those around them) were not appropriately investigated, and that the approach taken to his anti-psychotic medication was unreasonable.

We took independent advice from a psychiatrist. We found that the potential physical causes of Mr A's psychosis were reasonably investigated. We also found that the anti-psychotic medication Mr A was given was appropriate and necessary for his recovery, and that it was appropriate to continue Mr A on this medication after his discharge. We did not uphold Ms C's complaints.

Summary

Mr C complained about the treatment he had received at the Accident and Emergency Department at the Queen Elizabeth University Hospital. He had experienced leg pain for a number of months and was shortly going to go for planned surgery at a private hospital. A few days before the private surgery was due, his condition deteriorated and his leg felt numb. He was referred to the Accident and Emergency Department by his GP for a review and, after a few checks, was told to return home. Mr C's condition continued to deteriorate and he contacted the private hospital for advice and was told to return to Accident and Emergency. Following a scan it was diagnosed that Mr C had cauda equina syndrome (a spinal cord nerve disorder which can cause bladder and bowel disturbance as well as altered sensation in the saddle area). Mr C felt that there had been a failure in his treatment at the initial presentation to Accident and Emergency and that the diagnosis of cauda equina syndrome could have been made earlier.

We took independent advice from an emergency medicine adviser and an orthopaedic adviser (a specialist concerned with the musculoskeletal system). We found that, although the GP referral letter mentioned that Mr C had altered sensation in the saddle area (which is a red flag sign for cauda equina syndrome), observations in hospital had recorded that there was no numbness present around the anal area. We could not account for the conflict in information between the GP and the hospital. We did, however, note that a comprehensive examination and medical history had been taken in the Accident and Emergency Department and that Mr C had been advised to return to the Accident and Emergency Department or to contact the private hospital if his symptoms deteriorated. On balance we considered that Mr C had received a thorough assessment on initial attendance at the Accident and Emergency Department and that appropriate advice was given to seek further medical review should his condition deteriorate. We did not uphold the complaint.

Summary

Mr C complained about the practice’s management of his longstanding bladder and penile problems. He was diagnosed with an enlarged prostate (a gland in the male reproductive system) and underwent a surgical procedure. This was followed by further surgery to address a complication. After an initial improvement, his symptoms returned. He also began experiencing a lot of penile pain and irritation, for which he was referred to dermatology (the area of medicine concerned with the skin). Mr C complained that the practice failed to arrange appropriate investigations and treatment in response to his symptoms, including delays in referring him to urology (the area of medicine concerned with the male and female urinary-tractt, as well as the male reproductive organs) and prolonged ineffective treatment with antibiotics and creams.

We took independent advice from a GP who considered that Mr C’s symptoms were appropriately managed by the practice. We identified two occasions where earlier referrals to urology might reasonably have been considered. However, we did not find that the delays in referring to urology materially impacted on Mr C’s ongoing issues or the outcome for him. We considered that the practice appropriately managed Mr C's bladder and penile symptoms and did not uphold his complaints.

Summary

Mr C complained about the care and treatment provided to his wife (Mrs A) when she was an in-patient at Victoria Hospital. Mr C complained that the board failed to appropriately adjust her medication, that they did not provide her with reasonable physical rehabilitation, and that they unreasonably assessed her as needing a higher level of at home care, which Mr C said delayed Mrs A's discharge from hospital.

Summary

Mrs C complained that the board failed to provide her with appropriate care and treatment during her admission for day surgery at Queen Margaret Hospital. Following a procedure to remove her gallbladder, Mrs C was deemed to be fit to be discharged the same day. A number of days later she became unwell and was diagnosed with a serious infection.

Mrs C raised concern about whether the possibility of infection could have been foreseen and the decision to discharge her on the same day. She questioned why antibiotics were not prescribed and raised concern about the level of information she was given prior to discharge.

We took independent advice from a consultant upper gastrointestinal surgeon (a surgeon who specialises in the upper gastrointestinal tract which includes the gall bladder, liver, pancrease, oesophagus, stomach and small bowel). We found that there was no evidence of failings in the surgery provided to Mrs C. We found that there was no evidence of an active infection at the time Mrs C was discharged, and that it was reasonable, and in line with national guidelines, not to prescribe antibiotics. We did not consider that there was a reason to admit Mrs C overnight and were satisfied that the board had provided appropriate information to Mrs C prior to discharge. We did not uphold the complaint.

Summary

Mrs C complained about the care her daughter (Miss A) received at Midpark Hospital. Miss A has Asperger’s (a form of autism, in which people may find difficulty in social relationships and in communication) and suffers from depression, attention deficit disorder and personality disorder. She was admitted informally to the hospital for assessment and help. Mrs C complained that both the standard of psychiatric care and mental health nursing care Miss A received was unreasonable. Mrs C raised a number of concerns in relation to communication and the management, supervision and diagnosis of Miss A.

We took independent advice from a psychiatrist and a mental health nurse. We found that the standard of psychiatric care and mental health nursing in relation to communication, management, supervision and diagnosis was reasonable. We did not uphold Mrs C's complaints.

Summary

Mrs C complained that the care and treatment provided to her by the board was unreasonable. After having four wisdom teeth removed, Mrs C said that she suffered significant pain, but that clinicians failed to recognise this and treat her appropriately. Mrs C later required emergency care and was admitted to hospital, where she felt that clinicians were insufficiently prepared to discuss her care.

We took independent advice from a consultant oral and maxillofacial consultant (a doctor who specialises in treating diseases and injuries to the mouth, jaws, face and neck). We found that, whilst there was no doubt that Mrs C had been in a lot of pain following the removal of her wisdom teeth, the care and treatment she had received had been appropriate and reasonable. Therefore, we did not uphold this element of Mrs C's complaint. However, we did feedback to the board that they may wish to reflect on their interaction with Mrs C, as it was clear that she felt her concerns had been dismissed by them.

Mrs C also complained that the way the board dealt with her complaint was unreasonable. We found that the complaint was handled reasonably, and we did not uphold this part of Mrs C's complaint.