Not upheld, no recommendations

Summary

Mr C complained on behalf of his wife (Mrs A) that the ambulance service unreasonably failed to dispatch an ambulance following an emergency call and that they did not handle his complaint reasonably.

Mrs A had been diagnosed with a tumour at the rear of her brain and was waiting for an operation. Mr C said that Mrs A was told to call the emergency services if she experienced certain symptoms. When Mrs A subsequently experienced these symptoms, Mr C called the emergency services and spoke to a call handler who referred Mrs A to NHS 24. Mr C was unhappy that the ambulance service failed to dispatch an ambulance following the emergency call.

We took independent advice from a consultant in emergency medicine. We found that the information reported during the emergency call did not confirm that Mrs A had an immediately life-threatening condition, which would have required the dispatch of an ambulance as an emergency. The adviser noted that the decision to refer the call to NHS 24 in order to get a more detailed assessment of the situation by a clinically trained person was reasonable. We found that the decisions taken by the ambulance service were reasonable and therefore, we did not uphold this aspect of Mr C's complaint.

In relation to complaints handling, we found that the ambulance service had performed a detailed audit of the emergency call and that the member of staff involved had appropriately reflected on the call. We were satisfied that the complaint investigation carried out was reasonable and that the response to Mr C addressed the points he had raised. We did not uphold this aspect of Mr C's complaint.

Summary

Mr C complained on behalf of his late wife (Mrs A) about the treatment she received at Monklands Hospital. Mrs A attended her GP with pain in her right chest wall and was referred to hospital for an x-ray which found no significant abnormalities. Mrs A later attended her GP with worsening shoulder pain and her GP sent an urgent referral to the orthopaedics department (the branch of medicine concerned with the musculoskeletal system). This referral was downgraded by the board from urgent to routine. Mrs A was later diagnosed with bone and liver cancer. Mr C complained that the board unreasonably failed to check the x-ray for signs of cancer and that they unreasonably downgraded the urgent referral to routine.

We took independent advice from a consultant radiologist. We found that Mrs A had been referred for an x-ray due to an injury and that an x-ray is not the correct test to reliably pick up on a tumour. We also noted that the x-ray had showed a subtle change in bony texture of the clavicle (collar bone). As Mrs A had been referred for an x-ray due to an injury and the abnormality was so subtle, it would have been unreasonable to expect a radiologist to pick this up. Therefore, we did not uphold this aspect of Mr C's complaint.

In relation to the referral downgrade, we took independent advice from a consultant physician. We found that the orthopaedic referral letter did not suggest any need for the appointment to be urgent, no mention of cancer and no indication that the problem was considered to be anything other than shoulder pain that had not responded to physiotherapy. Therefore, we did not uphold this aspect of Mr C's complaint.

Summary

Mr C complained that the board unreasonably failed to provide him with appropriate care and treatment for his prostate cancer. He said that a consultant urologist (a doctor who specialises in medicine focusing on diseases of the urinary tract and the male reproductive organs) at Hairmyres Hospital advised him that his cancer was confined to his prostate, that it was T3 (had grown through the prostate capsule, outwith the prostate and was just outside the prostate) and that a laparoscopic radical prostatectomy (removal of the prostate via a small incision using robotic surgery) was an appropriate treatment. The consultant referred Mr C to a second consultant urologist at another board. Mr C said that when he was seen by the second consultant, he was told that the surgery proposed was not appropriate.

We took independent advice from a consultant urologist. We found that the first consultant referring Mr C for consideration of laparoscopic radical prostatectomy was appropriate and was in keeping with the West of Scotland Management Guidelines for prostate cancer. We found that, ideally, the first consultant should have pointed out that in their opinion Mr C's disease was suitable for radical prostatectomy, but that the final decision on suitability for surgery lay with the surgeon performing the surgery. The adviser explained that the main issue was one of a difference in clinical opinion between surgeons, and not a change in the extent of Mr C's cancer during the time between his appointments. On balance, we did not consider that the board unreasonably failed to provide Mr C with approprite care and treatment for his prostate cancer, and we did not uphold this aspect of the complaint.

Mr C also complained that the board unreasonably failed to arrange his referral for prostate surgery within a reasonable time and that they did not take the issue of the delay in arranging the referral appointment seriously. We found that the board had failed to respond to Mr C's phone calls about his referral and to take the issue of the delay seriously. We upheld this aspect of the complaint. We noted that the board had already apologised for this, and had taken steps to avoid this happening again in the future. We asked them to provide us with evidence of the action they had taken, however we made no further recommendations.

Summary

Mr C, a solicitor, complained on behalf of his client (Mr A) about the care and treatment he received at West Glasgow Ambulatory Care Hospital. Mr A was suffering from heart problems and was seen by a consultant cardiologist (a doctor who specialises in finding, treating and preventing diseases of the heart and blood vessels) and it was decided that no further investigations were appropriate. Mr C said that although Mr A continued to experience heart and chest pain, the board failed to take his concerns seriously and refused unreasonably to offer him appropriate treatment.

We took independent advice from a consultant cardiologist. We found that it was appropriate for the board not to investigate Mr A further as doctors had assessed the risks and benefits of more investigations and concluded, based on a number of points, that he should not be offered more. It was also noted that further cardiac investigations carried risks and could result in complications. We found that it was appropriate for no further tests to be carried out unless there was a solid indication to do so. Therefore, we did not uphold Mr C's complaint.

Summary

Ms C, who works for an advocacy and support service, complained about the care and treatment provided to her client's late father (Mr A) at the Southern General Hospital. Mr A had terminal cancer and other serious conditions, including heart failure. Mr A was admitted to the hospital after becoming unwell following chemotherapy. Ms C complained that the medical care he received for his complex presentation was unreasonable and highlighted concerns about him being given penicillin when his medical records noted he was allergic to this antibiotic. Ms C also complained that nursing staff had not treated Mr A with dignity and respect, and that staff communication with the family had been unreasonable.

We took independent advice from a consultant physician and geriatrician (a doctor who specialises in medicine of the elderly). We found that the medical care provided to Mr A had been reasonable for his condition and that he had not been allergic to penicillin. We did not uphold this aspect of the complaint.

We also took independent advice from a nursing adviser. We found that the nursing care provided to Mr A was reasonable and that there was no evidence that he was not cared for in a dignified manner. Consequently, we did not uphold this part of the complaint.

We found that there was evidence of reasonable communication with the family in the records. We did not uphold the complaint about communication with Mr A's family.

Summary

A number of years ago Mrs C was diagnosed as suffering from pseudoseizures (episodes that resemble, and are often misdiagnosed as, epileptic seizures). However, after a referral to cardiology from her GP some years later, it was determined that she had a heart problem and required a pacemaker. Mrs C subsequently had a pacemaker fitted and said that, since then, she had not suffered any further seizures.

Mrs C said that there had been a failure to recognise that her problems could relate to her heart, despite being under the care of the board in between her diagnosis with pseudoseizures and the diagnosis of a heart condition. She complained to the board, who responded and said that they felt her condition had been treated reasonably. They said that, until Mrs C was referred to cardiology, there had been no reason to suspect that she had heart problems. Mrs C was unhappy with this response and brought her complaint to us. Mrs C complained that, over the number of years she was under their care, the board had failed to diagnose and treat her heart condition.

We took independent neurology advice. We found that Mrs C was experiencing 'faints, fits or other funny turns' which, according to the relevant Scottish Intercollegiate Guidelines Network (SIGN) guidance, should prompt an electrocardiogram (ECG - a procedure used for measuring the electrical activity of the heart). We found that Mrs C was appropriately monitored with ECGs. For this reason, we did not uphold her complaint. We also noted that the ECGs, had not, in any event, revealed her heart problem, as only a prolonged recording would have been likely to have detected this.

Summary

Mr C, an MP, complained on behalf of his constituent (Mr B) about the lack of care provided to his late partner (Ms A) who had attended an out-of-hours service after reporting severe pain. Ms A was examined by the GP and sent home with laxatives (medication to help increase bowel movements). Ms A subsequently collapsed at home a short time later and died. Mr B obtained a copy of the death certificate which showed evidence of bowel obstruction. Mr B felt that due to the severity of the condition, the GP should have identified the problem and that the issue could have been rectified in hospital earlier.

We took independent advice from an adviser in general practice medicine and concluded that the GP had carried out an appropriate assessment of Ms A given her reported symptoms. She had a history of constipation and was on painkilling medication which would have contributed to her constipation. It would not have been appropriate to have prescribed additional painkillers as that would have worsened the constipation. We also found no evidence of bowel obstruction and, therefore, the decision to send Ms A home with laxatives to allow them time to take effect was reasonable. We found no medical requirement for a hospital admission at that time, and there was no information within the medical history or examination which would have alerted the GP to the subsequent events, or that the laxatives would not be effective. We did not uphold Mr C's complaint.

Summary

Mr C complained about the care and treatment that his wife (Mrs A) received at Aberdeen Maternity Hospital. Mrs A called and was seen at the hospital over a number of weeks with symptoms, including bleeding, before she suffered a miscarriage at 20 weeks into her pregnancy. Mr C was concerned about the care she received and that alternative action could have prevented the miscarriage.

We took independent advice from a consultant obstetrician (a doctor who specialises in pregnancy, childbirth and the female reproductive system). We found that the care Mrs A received at the hospital was reasonable and that there was no treatment to prevent spontaneous miscarriage at that stage of a pregnancy. We did not uphold the complaint.

Summary

Mrs C complained about the care and treatment she received during out-patient consultations at University Hospital Crosshouse. Mrs C initially attended a consultation in the renal medicine department (department of medicine relating to the kidneys) and it was felt that her test results showed that she had sub-clinical hypothyroidism (a condition where thyroid stimulating hormone level is higher than normal). Mrs C was prescribed a small dose of medication to treat this. Mrs C subsequently attended a consultation in a different department. This department did not agree that Mrs C had sub-clinical hypothyroidism and recommended that the medication should be stopped. A review appointment was arranged for three months' time. Mrs C was unhappy with this decision and undertook to self-source a supply of thyroid medication. She attended a further consultation in the renal medicine department approximately a year later. At this time, Mrs C was advised to discontinue taking her self-sourced thyroid medication as it was considered that it was causing suppression of her thyroid stimulating hormone. Mrs C disagreed with the board's findings and explained that she felt better taking the thyroid medication, which she reported had also improved her kidney function. She complained to us that the board were not providing her with the medication she felt she needed. Mrs C also complained that she was unreasonably advised to stop taking her self-sourced thyroid medication.

We took indepdendent advice from a consultant physician. We found that the test results over a number of years did not show evidence of sub-clinical hypothyroidism. For this reason, we considered it was reasonable for the board to discontinue the medication and to advise Mrs C of the risks of continued use. In relation to Mrs C's consultation in the renal medicine department a year later, we found that it was reasonable for the board to recommend that Mrs C stop taking the medication. We did not uphold Mrs C's complaints.

Summary

Mr C complained that Clear Business Water overcharged him for water usage. He said that the meter reading showed a higher consumption of water usage than his previous readings. Mr C also complained that he was unfairly charged for a replacement water meter. Clear Business Water investigated this complaint but found no failings in terms of the charges applied.

Clear Business Water advised Mr C that higher water usage can indicate a leak. Mr C had his property checked but found no leaks and believed that his water meter was faulty. He agreed for his water meter to be removed for testing and was advised that he would have to pay for the new meter installation, if his old one was found to be in working order. An accuracy test was carried out and the results showed that there was no fault with the recording of water usage.

We found that whilst Clear Business Water had acknowledged that the increase in usage may suggest a fault, at no stage was it confirmed that the meter was faulty or that it was being replaced because of a fault. In addition, although a marked increase in water usage had been noted, this in itself was not evidence of a fault with the water meter.

In terms of the charge applied for the replacement water meter, we found that Clear Business Water had provided clear advice in that Mr C would need to pay a charge if the original water meter was tested and found to be recording accurately. We found that they acted reasonably and, therefore, we did not uphold Mr C's complaints.