Not upheld, no recommendations

Summary

Ms C complained about the care and treatment provided to her by the board in relation to her hearing. Ms C had surgery to fit a hearing implant and after this she felt that her hearing deteriorated. Ms C also developed tinnitus (a ringing or buzzing in the ears). Ms C further complained that the communication with her from clinicians with regards to her hearing was not reasonable.

We took advice from an ear, nose, and throat consultant and an audiologist (a healthcare professional who specialises in hearing, balance and related disorders). We found that there was no suggestion that the reduction in Ms C's hearing was due to the surgery, and that clinicians involved in her care had provided a reasonable standard of care. We also found that the records showed a reasonable level of communication with Ms C. We did not uphold Ms C's complaints.

Summary

Mr C complained on behalf of his late wife (Mrs A) about the care and treatment she received from her GP practice. Mrs A attended the practice with stomach pains but it was not until two years after her pain began that she was diagnosed with cholangiocarcinoma (CCA, a very rare cancer of the bileduct). Mr C complained that the practice had delayed in carrying out appropriate tests and investigations. The practice said that Mrs A had been treated and cared for reasonably. They explained the rarity of her illness and said that that her symptoms had not been specific for a diagnosis of CCA. Mr C was unhappy with this response and brought his complaint to us.

We took independent advice from a GP. We found that, as well as Mrs A's illness being extremely rare, it was also very difficult to diagnose at an early stage and was often found incidentally. Mrs A initially attended the practice with abdominal pain for which she was appropriately treated. There was no indication at that time for further investigations and Mrs A noted an improvement. She did not return to the practice with abdominal pain until two years later. At this time, all her liver tests were normal; and showed no cause for concern. However, as her symptoms worsened, she was admitted to hospital and was diagnosed with CCA. We found that the care and treatment Mrs A received from the practice was reasonable and, therefore, we did not uphold this complaint.

Summary

Mr C complained on behalf of his late wife (Mrs A) who was diagnosed with cholangiocarcinoma (CCA, a very rare cancer of the bile duct) at Ninewells Hospital. Mr C was concerned that there had been a delay in providing the diagnosis and that, had appropriate tests and investigations been carried out sooner, Mrs A's death may have been avoided. Mr C was also concerned that after diagnosis, the board failed to make further more timely investigations about the spread of the disease (particularly to her bones) for which treatment may have been available. Mr C complained to the board who told him that Mrs A's illness had been life limiting but that throughout her illness, her treatment had been reasonable and appropriate. Mr C was unhappy with this response and brought his complaint to us.

We took independent advice from a consultant oncologist (a doctor who specialises in cancer treatment). We found that Mrs A's illness was very rare and diagnosis was not obvious; it was often an unexpected finding on a scan. Mrs A had stomach problems a few years before her cancer diagnosis, for which she received appropriate tests and at that time there was no evidence that she had cancer. Mrs A had no further stomach problems for two years until she was sent to hospital for a scan and it was at this time that she was diagnosed with CCA. We found that there had been no delay in diagnosis. After her diagnosis, Mrs A was given palliative chemotherapy (cancer treatment that is not designed to cure the disease, but rather prolong life and minimise symptoms) and responded well. Her symptoms were managed as it was not possible to operate, however, Mrs A was later admitted to hospital as she had become jaundiced (where the skin and/or eyes become yellow in colour). Her disease had progressed and was later found in her bones but we did not find that there had been any missed opportunities for treatment that would have changed Mrs A's outcome. We found that her care and treatment had been reasonable. Therefore, we did not uphold Mr C's complaint.

Summary

Ms C arranged an emergency appointment at the out-of-hours dental service as she was suffering from toothache. The dentist performed the first stage of a root canal treatment, however they experienced difficulty in accessing all the root canals. Ms C's tooth pain worsened and she had to return to the out-of-hours dental service the following day and she opted to have the tooth extracted. Ms  C complained that the dentist failed to properly explain the treatment options to enable her to give informed consent. She also complained the dentist failed to provide the appropriate treatment and that, had the dentist informed her of the difficulty they would have performing the treatment, she would have opted to have the tooth extracted.

The board explained that the dentist had difficulty accessing all the root canals and this would explain why Ms C had significant post-operative pain, however, they did not consider that the dentist failed to provide the appropriate treatment or that they failed to appropriately explain the treatment options.

We took independent advice from a dentist. We found that it was not possible to identify from scans taken of Ms C's mouth that the root canal treatment would be so difficult to perform, therefore the appropriate treatment was provided. We also found that the information provided to Ms C in terms of treatment options was reasonable in the context of an emergency service setting. We did not uphold Ms C's complaints.

Summary

Mrs C complained about the respiratory care (care of the lungs and other organs) and treatment provided to her by the board. She said that she did not feel she was given appropriate follow-up care and that this resulted in her respiratory problems becoming worse.

We took independent advice from a consultant in respiratory medicine. We found that Mrs C was appropriately investigated and that no follow-up was necessary. We also found that there was no evidence that her respiratory problems had been caused by, or became worse as a result of, lack of follow-up. We did not uphold Mrs C's complaint.

Summary

Mrs C attended the practice with symptoms of a hoarse voice, burning and tightness in her chest, decreasing over five days. Mrs C explained to the practice that she was due to go on holiday in three days and queried whether she was fit for travel. The doctor considered that she was suffering from a viral infection, recommended fluids and paracetamol and considered her to be fit for travel. However, in the following days her condition worsened, causing her to attend a hospital's emergency department who prescribed antibiotics. Mrs C was still unwell when her holiday commenced. Mrs C complained that the practice had not provided her with reasonable treatment, which caused her to be unwell on her holiday.

We took independent advice from a GP. Based on the information available at the time, we considered that the practice provided a reasonable standard of medical treatment and that the practice could not have foreseen that Mrs C's condition would worsen, impacting on her holiday. Therefore, we did not uphold the complaint.

Summary

Mr C complained about the care and treatment provided to his late father (Mr A) at Monklands Hospital. Mr A had terminal cancer and was admitted to hospital after he developed pneumonia (a lung infection). Following admission, Mr A received an x-ray, pain medication, fluids and antibiotics, and test results indicated that he had neutropenic sepsis (a potentially fatal complication of anti- cancer treatment in which the ability of bone marrow to respond to infection is supressed). During the admission, doctors considered whether to transfer Mr  A to the Intensive Care Unit (ICU). It was felt that, due to the severity of Mr  A's presenting illness as well as the background of cancer undergoing palliative treatment (end of life treatment), ICU treatment would not have altered his chance of survival. Mr A continued to receive treatment on the medical ward, and he died the day following admission to the hospital.

Mr C was unhappy that Mr A was not treated in ICU and he felt that Mr A did not receive appropriate care and treatment during the admission. We took independent advice from a consultant in acute medicine. We found that Mr A received rapid assessment and treatment on admission to the hospital and we considered that the care provided was reasonable. We also considered that the board's decision not to treat Mr A in ICU was reasonable in the circumstances. The adviser noted that specialist cancer nurses had been involved in Mr A's care and they considered that the care provided both before and after the nurses' involvement was reasonable. We did not uphold Mr C's complaint.

Summary

Following a fall at home, Mrs C was taken to Wishaw General Hospital where scans were taken. Mrs C was told by a doctor that the scan results suggested that breast cancer, which she had suffered from previously, had returned. Discussions were held with the breast cancer nurse and the oncology (cancer  treatment) department, who were not convinved that the results were evidence of metastases (when cancer spreads from the initial site to a secondary site). Mrs C had to wait until the outcome of further scans over an eight week period before being told that her condition was benign (non-cancerous) and that there was no metastases. Mrs C complained that it was inappropriate for staff to have told her that scans had shown the possibility of metastases.

We took independent advice from a consultant radiologist. We found that it was reasonable for staff to conclude that intial scan results showed signs which could have been attributable to metastases. We found that Mrs C had symptoms that are considered concerning for metastatic disease from breast cancer. We, therefore, considered that it was appropriate to make Mrs C aware of the concerns around potential metastases. We also found that there was no delay in reaching a definite diagnosis. We did not uphold the complaint.

Summary

Mr C noticed a lump in his chest and he was concerned that it was related to a previous abscess (a painful swelling caused by a build-up of pus) he had suffered with. His GP referred him to Hairmyres Hospital for a scan, where it was found that he had an abscess in the fat under the skin that was unlikely to be tracking elsewhere in his body. Mr C had a procedure to have this abscess drained at the hospital and afterwards he began to feel very unwell. He attended a private hospital and was found to have a very large, deeper abscess that was spreading down under his liver and pushing up to his chest. Mr C complained that the board had unreasonably failed to diagose and treat this abscess.

We took independent advice from a consultant vascular and general surgeon. We found that Mr C's condition was appropriately assessed and investigated when he attended the hospital. The adviser explained that the scan that had been taken did not show any deeper abscess. We noted that Mr C did not have symptoms that suggested a larger, deeper abscess. We found that, although Mr  C would have had the larger, deeper abscess when he attended the hospital, the failure to diagnose was not unreasonable. We did not uphold Mr C's complaint.

Summary

Ms C complained about the treatment she received at Wishaw General Hospital. Ms C became pregnant and had a high body mass index (BMI, a measure for estimating human body fat) when she booked in for a scan. As a result, Ms C was tested for gestational diabetes (diabetes that develops in women who did not have diabetes before their pregnancy) and was later prescribed medication to reduce her high blood sugar levels. This dose was later increased as her blood sugar levels remained high. Ms C was admitted to hospital as her baby stopped growing and had an emergency caesarean section to deliver her baby. After she was discharged home, Ms C developed an infection and her stitches burst. She later went on to develop nerve damage and fibromyalgia (a long term condition that causes pain all over the body). Ms C complained that the treatment she received towards the end of her pregnancy led to nerve damage and fibromyalgia.

We took independent advice from a consultant obstetrician and gynaecologist (the medical specialty that deals with pregnancy, childbirth, and the post-partum period and the health of the female reproductive systems and the breasts). We found that Ms C was correctly started on medication because of her persistently high blood sugar levels and that this helped with problems associated with gestational diabetes. This was in keeping with national guidelines. We noted that Ms C's high BMI and gestational diabetes were significant risks in pregnancy and wound healing. While Ms C suffered nerve damage and developed fibromyalgia, these were not known to be associated with caesarean section surgery. Therefore, we found that she had been treated reasonably and appropriately. We did not uphold Ms C's complaint.