Not upheld, no recommendations

Summary

Mr C, who is an MSP, complained on behalf of his constituent (Mr A). He said that the board had failed to provide Mr A with reasonable care and treatment in relation to blisters, fluid, diabetes, constipation and ventilation whilst he was in Hairmyres Hospital. Mr C also complained that that the day after Mr A was discharged, he was admitted to another hospital with renal failure.

We took independent advice from a consultant in acute medicine and from a nursing adviser. We found that Mr A did not develop renal failure as a result of the treatment he had received in hospital. He had chronic kidney disease and this was a longstanding problem that was worsening. Based on his blood tests on admission and discharge as well as what was documented in the notes, we found that it had been likely that he would end up on dialysis (a form of treatment that replicates many of the kidney's functions). That said, Mr A did not seem to be fully aware of this and we brought this to the board's attention.

We also found that the care and treatment Mr A received in relation to blisters and fluid management was reasonable and that there was no evidence in the records to indicate that he was ignored by staff when he informed them of developments regarding his health. In their response to Mr A's complaint, the board had apologised that he was given sugar with his drinks and had stated that they had asked the hostess to review her protocol in relation to this. They had also apologised that one of Mr A's laxatives was not prescribed, although we found that Mr A had received other laxatives and that his constipation had been alleviated. In addition, the board had apologised that he found the temperature in the ward uncomfortable.

On balance, we did not consider that the overall care and treatment provided to Mr A in the hospital had been unreasonable, particularly in relation to the most severe areas such as renal failure. We accepted there were some areas of care that the board acknowledged fell short of expectation, particularly in how some aspects of his care were communicated, but we considered that the board's response to these was reasonable and the steps they took to address the issues were what we would have asked them to do to prevent recurrence. On balance, we did not uphold Mr C's complaints.

Summary

Miss C and Miss B complained to us about the care and treatment their uncle (Mr A) had received from the board. Mr A had been admitted to Monklands Hospital with shortness of breath. He was discharged from hospital three weeks later. Miss C and Miss B complained that it had been unreasonable to discharge Mr A at that time because of his immobility and a lack of adequate discharge arrangements.

We took independent advice from a consultant in acute medicine. We found that Mr A had been medically fit for discharge, although there were some concerns about how he would manage. Although we found that, ideally, there should have been additional support in place for Mr A when he was discharged, we did not consider that the discharge arrangements the board put in place were unreasonable. On balance, we did not uphold this aspect of the complaint.

Miss C and Miss B also complained about the care and treatment Mr A received from both medical and nursing staff at his home when his condition deteriorated. We found that the care and treatment provided to Mr A, including treatment for an infection, had been reasonable. We did not uphold this aspect of the complaint.

Mr A was subsequently readmitted to hospital and died there two days later. Miss C and Miss B complained to us about the standard of care and treatment provided to Mr A in hospital before his death. We found that there had been a short delay in communicating Mr A's deterioration to his family and that the timing in relation to asking the family to complete a document about his interests and preferences at the time he was deteriorating was inappropriate and insensitive. However, we found that the care and treatment provided to Mr A had been reasonable and appropriate. It was also reasonable that he was not transferred to the intensive care unit. In view of this, we did not uphold this aspect of the complaint.

Summary

Ms C complained about the care and treatment provided to her late partner (Mr A) by GPs at the practice. Ms C complained that GPs incorrectly diagnosed a viral illness, and that they should have recommended hospital admission at an earlier point.

We took independent advice from a GP. We found that, on the two occasions that GPs from the practice attended Mr A, they assessed and examined him reasonably and that, based on this, the diagnosis of viral illness was reasonable as there was no evidence of any more serious cause of Mr A's illness. We did not uphold this complaint.

Summary

Ms C complained about the care and treatment provided to her late partner (Mr A) by an out-of-hours GP and at Belford Hospital. She complained that the GP did not reasonably assess Mr A and that, when he was later admitted to hospital, there was a delay in diagnosis which resulted in no treatment options being available for his perforated duodenal ulcer (when the lining of the stomach splits due to a sore).

We took independent advice from a GP and a consultant physician. We found that the care and treatment provided to Mr A by the GP was of a reasonable standard and that his symptoms were most fitting with a diagnosis of viral illness at this time. We also found that, whilst there was some delay in diagnosing Mr A when he was admitted to hospital (which the board had acknowledged), this did not have any impact on Mr A's outcome as, due to his other illnesses, surgery would not have been an option for him. We did not uphold this complaint.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Ms A). Over the past twenty years Ms A has suffered from balance issues and problems with her eyes. Over a period of years, Ms A attended the ophthalmology (eye) and neurology (brain and nervous system) departments of Raigmore Hospital. Her symptoms were assessed and investigated and she was referred for a second opinion, but no causes were found for her symptoms. The ophthalmology department decided not to arrange further appointments for her and it was suggested that she attend the rehabilitation clinic. Ms A considered that clinicians had given up on her and that she had been disbelieved. Ms C complained to us that the decision to discharge Ms A to the rehabilitation clinic was unreasonable, as she had not yet been diagnosed.

We took independent advice from consultants in ophthalmology and neurology. We found that all of Ms A's care and treatment had been reasonable and appropriate but that, despite this, Ms A's symptoms remained. It was acknowledged that this was very challenging for her, however we considered that the absence of a diagnosis or abnormal test findings did not mean that she had been disbelieved. Furthermore, we found that it was sensible and reasonable to refer her to the rehabilitation clinic which was best placed to deal with her continuing condition. We did not uphold the complaint.

Summary

Ms C complained to us that the practice had failed to provide appropriate care and treatment to her when she reported symptoms of altered bowel habit. When she was referred to hospital cancer specialists after a period of some months it was established that she had bowel cancer. Ms C belived that the practice should have referred her to the hospital cancer specialists earlier and that the diagnosis would have been reached sooner.

We took independent advice from a GP adviser and concluded that there were no delays in the practice making a referral for a specialist hospital opinion. Ms C had attended the practice on a number of occasions with a number of physical and psychological symptoms and initially it was felt that a referral to a respiratory clinician was appropriate. However, when Ms C continued to report different symptoms it was then appropriate for a referral to be made to the hospital cancer specialists. We found this to be reasonable and we did not uphold the complaint.

Summary

Mr C complained about the care and treatment his late mother (Mrs A) received at Queen Elizabeth University Hospital. Mrs A suffered from kidney failure. Mr C complained that her high blood pressure was not properly managed and that the care and treatment provided to her during three hospital admissions was not of a reasonable standard.

We took independent advice from a consultant nephrologist (a consultant who specialises in the kidneys). We found that Mrs A's blood pressure was managed appropriately, and that the care and treatment provided to her when she was an in-patient was reasonable. We did not uphold these aspects of Mr C's complaint.

Mr C also complained that a nurse did not provide him with an appropriate level of information when notifying him of his mother's admission to hospital. Based on the evidence available, we found that the level of information provided to Mr C was appropriate. We did not uphold this aspect of Mr C's complaint.

Summary

Ms C complained that the practice failed to provide a reasonable standard of medical care and treatment to her late father (Mr A). Mr A attended appointments at the practice over a period of two months. Mr A was initially referred to hospital by the practice to be assessed for deep-vein thrombosis (DVT, a blood clot that develops within a deep vein in the body) and was prescribed medication. The results of the ultrasound scan taken at the hospital did not indicate DVT and the medication was stopped, however, Mr A's condition deteriorated. He attended two more appointments at the practice but died of a pulmonary embolism (a blocked blood vessel in the lungs) a few days after his final appointment. Ms C said that the practice had failed to see that Mr A's symptoms indicated DVT and believed that his death could have been prevented. Ms C also complained that the practice failed to respond to her complaint in a reasonable way.

We took independent advice from a GP. We found that the medical care and treatment was of a reasonable standard based on the evidence provided and the information available to the practice at the time in question. We also noted that the practice fully addressed the issues raised and took account of the clinical evidence available when responding to Ms C's complaint. Therefore, we did not uphold Ms C's complaints.

Summary

Mr C complained that the prison healthcare centre's decision to stop his suboxone medication (medication used to treat opium addictions) was unreasonable. A prison nurse reported that Mr C appeared to act suspiciously when they were administering his suboxone medication. They did not consider that Mr C gave them an adequate opportunity to confirm that the medication had been taken correctly. His medication was subsequently stopped and he was later given methadone as an alternative opiate replacement therapy. Mr C disputed the nurse's allegation that he did not comply and brought his complaint to us.

We took independent advice from a GP. We found that Mr C's suboxone was stopped as prison healthcare staff felt that he had not complied with the instructions set out in the contracts. Mr C had signed two contracts in relation to medication and one of these declared that he understood he would be taken off suboxone if caught or suspected of concealing medication. Healthcare staff suspected that he was concealing medication and they were, therefore, entitled to act on that suspicion if they felt that there was a risk of clinical harm to Mr C and/or the good order within the prison. The adviser raised no concerns about the decision taken to stop Mr C's suboxone and we considered that this decision was reasonable in light of Mr C's suspected non-compliance. Therefore, we did not uphold this complaint.

Summary

Mr C attended his GP practice with symptoms of fatigue, reduced appetite and night sweats. Tests indicated an infection and Mr C was prescribed antibiotics and referred to hospital. Several weeks later, after discussing the matter with the GP, Mr C decided to cancel the hospital appointment offered. However, Mr C was unaware that the referral to hospital mentioned the possibility of serious pathology (red flag symptoms). When Mr C had the same symptoms a year later, an x-ray showed suspected cancer in his right lung and further tests showed stomach cancer.

Mr C complained that failings by the practice meant that he had been unable to make an informed decision about the initial referral the year before and that his life had been shortened considerably. Mr C complained that the practice failed to provide him with a reasonable standard of medical care.

We took independent advice from a GP. Overall, we found that the standard of medical care and treatment provided was reasonable. We were satisfied that Mr C had been investigated appropriately and that the tests taken were thorough. Therefore, we did not uphold the complaint.