Not upheld, no recommendations
Summary
Mrs C complained to us about the care and treatment her sister-in-law (Mrs A) received at the Royal Infirmary of Edinburgh after taking two overdoses of medication within a few days. On the first occasion, Mrs A was assessed in the emergency department for risk of liver damage and then admitted to the acute medical unit. She had a psychiatric assessment the following morning and it was decided that she did not need any further in-patient psychiatric care. Mrs A discharged herself from the hospital later that day against medical advice. Mrs A was brought back to the emergency department on the following day after taking a further overdose and was then admitted to the toxicology unit. On the following day, she was transferred to a specialist liver transplant unit, although it was decided that she was not a candidate for a liver transplant. She was subsequently moved to intensive care after it was recorded that her kidneys were failing. Mrs A died there several days later. Mrs C complained about the care and treatment provided to Mrs A during each admission to the hospital.
We took independent advice from an emergency medicine consultant, a psychiatric consultant, a general medical adviser and a consultant in anaesthesia and intensive care medicine. We found that the care and treatment provided to Mrs A in the hospital throughout all admissions had been reasonable and appropriate. We did not uphold Mrs C’s complaints.
Summary
Mrs C complained to us that the medical practice had failed to provide appropriate care and treatment to her mother (Mrs A) at a home visit. She said that her mother had been dizzy, light-headed and off her feet and that she suffered from high blood pressure. Mrs C said that the GP recognised her mother's high blood pressure but did not take any further action and told her to wait for the district nurses, who were scheduled to visit in three days time, and that they would take further blood pressure readings, which Mrs C considered to be unreasonable. Mrs C called out the out-of-hours GP later that evening as her mother's blood pressure was still high. The offer of a hospital referral was made but Mrs A declined the offer. Mrs A was admitted to hospital two days later for a suspected heart attack and remained a patient for nearly two weeks.
We took independent advice from a GP adviser and concluded that the practice had provided a reasonable level of care. We found that the GP had carried out a reasonable examination and had concluded that there was no indication of an acute illness. The GP felt that the cause of the high blood pressure was caused by Mrs A's anxiety. It was appropriate to check the blood pressure readings and we considered that, as the district nurses were scheduled to visit a couple of days later, the matter would receive appropriate follow-up at that time. We did not uphold the complaint.
Summary
Mrs C complained to us about the care and treatment she received at Wishaw General Hospital following a fall at her home. Mrs C had hit her face and suffered deep cuts to her head which required stitches. Mrs C also sustained a fracture to her wrist. Mrs C was concerned that she was not admitted to hospital for observation and that no x-ray or scan was taken of her head.
We took independent advice from an adviser in emergency department medicine. We concluded that Mrs C received a thorough assessment when she attended the Minor Injuries Unit and that appropriate follow-up at the Fracture Clinic and Ear, Nose and Throat deparment were made. We found that there was no clinical justification for staff to arrange a head x-ray or a scan when Mrs C attended the hospital and that there was no requirement for her to be admitted to hospital for further observations. We did not uphold the complaint.
Summary
Mr C complained about the care and treatment provide to his late father (Mr A) by the practice. Mr A was referred to a cardiology consultant (a doctor who specialises in the heart and blood vessels) by his GP following complaints of breathlessness. The consultant gave the practice some guidance about future treatment, and Mr A visited the practice a number of times over the next few weeks. Some changes to his medication were made and he was again referred to cardiology. Following this, Mr A was diagnosed with pulmonary fibrosis (a rare condition causing scarring of the lungs) and he died a few weeks later. Mr C complained that the practice had not followed the guidance of the consultant.
We took independent advice from a GP adviser. We found that the practice did follow the advice of the consultant, and that the eventual diagnosis of pulmonary fibrosis could not have been foreseen during the period when the practice was responsible for Mr A's care. We did not uphold the complaint.
Summary
Mrs C, who works for an advocacy and support service, complained on behalf of her client (Mr A) about the care and treatment provided to him by his GP. Mr A had suffered a tick bite which had left him with a red rash. Mr A said that the GP dismissed his concerns, and that, following the bite, he had a number of symptoms such as flu like issues, stomach pains, joint and bone pain and neck stiffness. Mr A believed that the GP should have completed further blood tests and carried out investigations to determine if he had Lyme disease (a bacterial disease caused by tick bites).
We took independent advice from a GP adviser. We found there was no corroboration that Mr A had suffered a rash following the bite. The GP had recorded that there was a red lump at the site of the bite, but no rash, and had noted that they thought this was more likely to be a skin infection than a rash associated with Lyme disease. We found that the GP had prescribed antibiotics for a skin infection, and had advised Mr A to look out for symptoms of Lyme disease and what to do should he develop symptoms. We found that the GP had acted reasonably and we did not uphold the complaint.
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.