Not upheld, no recommendations

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.

Summary

Mrs C complained about the care and treatment she received at Wishaw General Hospitial in relation to her fertility treatment. In particular, Mrs C stated that she had been misinformed that the medication she was taking would not affect her fertility.

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 the correct investigations in relation to Mrs C fertility problems had been performed in a timely manner. We also noted that it was explained to Mrs  C at an early stage about the contributory factors to the fertility problems she was experiencing and the treatment which would be required. We found that there was no evidence that Mrs C had been misinformed about the cause of her fertility problem and that she had been kept advised of the results of the various investigations carried out as they proceeded. Therefore, we did not uphold the complaint.

Mrs C also complained that the board had failed to adequately address her complaint. We found that the board had handled the complaint in line with their complaint process and had offered the opportunity to meet with senior staff to address any outstanding questions. We did not uphold the complaint.

Summary

Mrs C complained that the care and treatment she received at Raigmore Hospital, in relation to problems with her gallbladder, was unreasonable. She said that on several occasions she attended an out-of-hours GP and the emergency department but her symptoms were not investigated and as a result, when she was diagnosed with cholecystitis (inflammation of the gallbladder), the surgery was complicated and her recovery was difficult.

We took independent advice from a GP, a consultant in emergency medicine, and a surgeon. We found that the care and treatment provided to Mrs C was of a reasonable standard and there was no indication of gallbladder problems at her attendances prior to the diagnosis of cholecystitis. We did not uphold Mrs C's complaint.

Summary

Miss C complained about the length of time which she was going to have to wait for an appointment at an orthopaedic clinic (a clinic for conditions involving the musculoskeletal system). Following a car accident a number of years ago Miss  C had seen a number of health professionals. She also took numerous forms of medication but remained in severe pain. Her GP referred her to the orthopaedic clinic and the referral was marked as routine. After six months Miss  C had not received an appointment date. Her GP made a further referral to orthopaedics, and was told that the current waiting time was 48 weeks. Miss  C complained that, despite two referrals from her GP, her case was not being treated as urgent by the board.

We took independent advice from an adviser in orthopaedic medicine. We found that, although the board had not managed to arrange the orthopaedic appointment within the treatment time guarantee, they had apologised for the delay and had explained what action they were taking in an effort to reduce waiting times. We found that the board had correctly classified both of the GP referral letters as routine rather than urgent based on the information provided by the GP. We did not uphold the complaint.

Summary

Mrs C complained about the treatment she received at the Queen Elizabeth University Hospital following a hysterectomy (surgical removal of the uterus). The morning following the surgery Mrs C received a blood thinning injection and when she was discharged later that afternoon she was given an information leaflet on exercises to undertake at home. Just over a week following the discharge, Mrs  C developed breathing difficulties and a high temperature and attended hospital where it was found she had suffered a pulmonary embolism (a blockage of an artery in the lungs) and required further blood thinning injections. Mrs C felt that she was not given sufficient blood thinning injections following the surgery and that she had been discharged home too early.

We took independent advice from a medical adviser and found that, following her surgery, Mrs C's observations were found to be normal and that she was able to eat and drink and was mobile. We also found that she had been fitted with TED  stockings (stockings that help to prevent blood clots) and had received a blood thinning injection within a reasonable timeframe following the surgery. We concluded that it was appropriate to have discharged her from hospital and that there was no clinical indication that she would then go on to develop a pulmonary embolus. We did not uphold Mrs C's complaints.

Summary

Mrs C complained that the practice had failed to provide appropriate care and treatment to her husband (Mr A) when he reported mobility problems following a fall where he was hit by a car door. Mr A had a history of ankylosing spondylitis (a type of arthritis in the spine). Following the fall, a nurse practitioner made a home visit and, after speaking to a GP, a diagnosis of a dead leg syndrome was made. Mr A continued to deteriorate and a further call was made to the practice the following day. Mr A was then admitted to hospital where he was diagnosed as having two unstable fractured vertebrae (bones in the spinal column).

We took independent advice from a GP adviser and from a nursing adviser. We found that, based on the symptoms first reported by Mr A, there was no indication of a serious illness and that he did not require a hospital admission that first day. We found that it was appropriate that it was only when his condition deteriorated and he reported some numbness that it was deemed necessary to contact the hospital specialists and arrange for Mr A to be admitted to hospital. We did not uphold the complaint.