Not upheld, no recommendations

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.

Summary

Miss C complained about the time taken to refer her to a specialist in a different board area for her urology issues (urology is the area of medicine relating to the kidneys, bladder and urinary tract). She said she asked for this referral repeatedly, but that it took a number of months for the board to refer her. She also complained that the board did not send on some test results to her new consultant, so she was required to repeat these privately at her own cost.

In response to Miss C's complaint, the board said that referrals to another health board are not available on demand. They said that the consultant who reviewed Miss C's case and made the referral felt that it was appropriate to refer her on for more specialist advice at that time. The board acknowledged that they did not include a copy of the test results with the original referral, and they apologised for this. They said they had sent on the test results about two months later.

We took independent advice from a consultant urologist. We found that Miss C's condition was first investigated by gynaecology (the area of medicine that deals with the health of the female reproductive systems and the breasts) and, while Miss C did request a referral to the specialist during this time, she then agreed to continue with additional tests. Miss C then advised the gynaecology service that she was now seeing a private gynaecologist, and she was appropriately discharged from their care. About six months after this first urology appointment, Miss C was reviewed by urology, and there is no evidence in the medical records that she requested a referral to the specialist before this review. We considered that this time-frame was reasonable, and there was insufficient evidence to conclude that the board had failed to respond to her request for a referral. We did not uphold this aspect of Miss C's complaint.

In relation to the test results, we found there was evidence that the board did send these on two months after the referral (although it appeared they were never received by the specialist). We found the delay was unreasonable, but noted that the board had already apologised for this. We found that it was likely the specialist would have asked Miss C to repeat these tests in any case, so we did not recommend that the board refund this cost. We did not uphold this aspect of Miss C's complaint.

Summary

Mr C's late mother (Mrs A) was receiving palliative care (end of life care) for advanced pancreatic cancer at home in a sheltered housing complex. Mr C contacted the out-of-hours service a number of times over a weekend, as he was concerned about the amount of pain that Mrs A was in. On the Sunday evening, Mrs A was admitted to hospital and transferred to a hospice the following day, where she died several days after. Mr C complained that the board failed to provide a reasonable standard of medical care and treatment and that they failed to respond to his complaint in a reasonable way.

We took independent advice from a specialist in general practice medicine. We found that the medical care and treatment provided to Mrs A was of a reasonable standard and that she was admitted to hospital within a reasonable time. In relation to complaints handling, we found that the board had fully addressed the issues raised and took account of the evidence available at the time. We did not uphold Mr C's complaints.

Summary

Mr C complained about the treatment which his late brother (Mr A) received when he attended the accident and emergency department at Dumfries and Galloway Royal Infirmary. Mr C had received a phone call from Mr A early one morning saying that he had difficulty breathing. An ambulance was called and took Mr A to the hospital. Later that morning Mr C received a further call from Mr A saying that he was being discharged from the hospital and asking Mr C to pick him up. Mr C ensured that Mr A was settled in his house. However, Mr C later learned that Mr A had died. The cause of death was heart failure and Mr C felt that more care should have been taken at the hospital and that perhaps Mr A should have been admitted for further tests.

We took independent advice from a consultant in emergency medicine. We found that the staff at the accident and emergency department had carried out an appropriate examination of Mr A at the time, which included a history of heart problems. They had taken a chest x-ray, electrocardiogram (ECG - a test to check the heart's rhythm) and blood tests. Although there were subtle signs of heart failure from the results, we concluded that it was reasonable for the staff to diagnose that Mr A was suffering from a chest infection rather than heart failure. It was also reasonable that Mr A was prescribed antibiotics and discharged home. We did not uphold the complaint.

Summary

Miss C was due to have surgery on her leg at Dumfries and Galloway Royal Hospital but this was cancelled shortly before the scheduled time. Miss C complained that the board did not carry out her surgery and that the reasons for this were not properly explained to her. While the board apologised for the confusion surrounding the decision to cancel Miss C's surgery, they felt that the decision was appropriate as it was a major operation with significant risks and she had shown some recent improvement. Miss C was unhappy with this response and brought her complaint to us.

We took independent advice from a consultant vascular surgeon. We found that it was reasonable for the operation not to have been performed, but we considered that the decision-making process surrounding this could have been clearer. We found that the entries made at the time in Miss C's medical records indicated that the reasons for not going ahead with the surgery had been explained to her. We did not uphold Miss C's complaints but provided feedback to the board regarding their decision-making process for surgery in complex cases.

Summary

Mrs C complained about the care and treatment provided to her husband (Mr A) by the practice. Mr A attended the practice feeling unwell, having had a history of heart problems. In the following weeks Mr A was admitted to hospital where he was diagnosed with a condition in his heart. Mr A suffered an injury in the brain as a result of a bleed, and his short term memory has been impacted by this. Mrs C considered that if the heart condition had been diagnosed earlier, then Mr A's eventual outcome may have been different.

We took independent advice from a GP adviser. We found that the symptoms described and noted were not indicative of a particular illness. We also found that the classic symptoms of Mr A's condition were not seen until the day Mr A was admitted to hospital. We found that the GP took reasonable steps to establish the reason for Mr A being unwell and carried out appropriate tests. We also considered that the GP made an appropriate referral to a cardiologist (a  doctor who specialises in finding, treating and preventing diseases of the heart and blood vessels). The referral to the cardiologist was not sent as a matter of urgency. The GP surgery acknowledged this error and took steps to ensure that this did not happen again. We found that, even if the referral had been sent urgently, this would not have had an impact on the outcome. We did not uphold the complaint.