Not upheld, no recommendations

Summary

Ms C attended a dental practice for emergency treatment as she was experiencing tooth pain. Ms C complained that the dentist treated the wrong tooth and failed to identify an infection in her wisdom tooth. The practice confirmed that the dentist performed the first stage of a root canal treatment in the tooth that they identified as causing Ms C's pain. They also confirmed that there was no infection present in Ms C's wisdom tooth on the day of her appointment. Ms C was unhappy with this response and brought her complaint to us.

We took independent advice from a dentist and found that Ms C's dentist carried out a thorough assessment of her symptoms. We noted that the dentist treated the tooth that was identified as causing the pain following a series of tests, including an x-ray. We also found no evidence of an infection in the wisdom tooth and, therefore, it was likely that the infection developed after the appointment. We considered that the treatment Ms C received was reasonable and, therefore, we did not uphold her complaint.

Summary

Miss C complained that the plans made for her labour at the Royal Infirmary of Edinburgh were unreasonable. Specifically, that she was refused a caesarean section and induction of labour, and that she was advised not to call an ambulance when going into labour. Miss C also complained that staff included inaccurate information, about a consultation, in correspondence to her GP.

We took independent medical advice from a consultant obstetrician and found that there was no evidence to show that Miss C was refused a caesarean section or induction of labour. We considered that it was reasonable of board staff to recommend against a caesarean section in this case, given the complications associated with the operation. We also considered that advice given not to call for an ambulance outside an emergency situation was appropriate. Therefore, we did not uphold this complaint.

We were also satisfied that a member of staff had not unreasonably included inaccurate information to Miss C's GP and, therefore, did not uphold this complaint. However, we provided feedback to the board that there appeared to have been some miscommunication regarding the matter.

Summary

Mrs C, an advocacy and support worker, complained on behalf of her client (Mr B) who had concerns about the way the medical practice had managed his mother (Mrs A)'s oxazepam medication (for anxiety and to be taken for short periods only). He said that Mrs A had been taking the medication for a number of years and that the practice had recently reduced the medication and, as a result, Mrs A suffered a stroke. She was taken to hospital and died of a further stroke a number of days later. Mr B felt that the stress of the medication reduction caused Mrs A to suffer a stroke.

We took independent advice from an adviser in general practice medicine and found that the practice had managed Mrs A's medication regime in an appropriate manner. Care has to be taken with oxazepam medication as it can cause both psychological and physical addiction. Practices have a responsibility to keep medication under review to ensure that it is still required and if it is not, they must reduce it or stop the medication completely. We found that there was evidence from the records that Mrs A was initially not requesting the medication on a regular basis but recently had made increased requests. This made it necessary to review and reduce the medication to an appropriate level. There was also no evidence that the reduction in medication led to Mrs A suffering a stroke. Therefore, we did not uphold the complaint.

Summary

Mr C complained to us that the practice had failed to provide appropriate treatment to his late wife (Mrs A). Mrs A had been attending a hospital out-patient department for a separate matter and had been advised to make an emergency GP appointment as she was showing symptoms of a cough and breathlessness. Mrs A developed deep vein thrombosis (DVT, blood clot in a large vein) four days after the consultation and later died. Mr C believed that the practice should have referred his wife to hospital at the time of the appointment.

The practice responded that Mrs A was given an emergency appointment following her attendance at the out-patient clinic. However, the reason for the appointment was for anxiety problems and Mrs A only reported symptoms of low mood and that her heart was racing. Mrs A did not report symptoms of having a cough, chest pain, shortness of breath, or pain or swelling in her leg. The practice prescribed anti-depressant medication and diagnosed anxiety problems.

We took independent advice from an adviser in general practice medicine and concluded that, from the entries in Mrs A's medical records, the practice had provided a reasonable level of care. There was no indication that Mrs A had reported symptoms suggestive of DVT and the medication prescribed by the practice was appropriate for symptoms of anxiety and low mood. There was also no indication that a hospital referral was required at that time. We did not uphold the complaint.

Summary

Ms C complained on behalf of her late father (Mr A) about the care and treatment he received from the practice prior to his diagnosis of cancer. Mr A presented at the practice with a swollen jaw and neck and was advised to visit his dentist immediately. Mr A later attended the out-of-hours GP service. The practice received the out-of-hours report that stated Mr A had an upcoming appointment at hospital and that he had been referred to an ear, nose and throat specialist. Ms C later contacted the practice as Mr A had become more unwell and an admission to hospital was agreed. Mr A was diagnosed with cancer and died not long after his diagnosis. Ms C complained that more could have been done by the practice to speed up the diagnosis.

We took independent advice from a medical adviser. They reviewed the records and were satisfied that the practice had provided reasonable care at each point of contact. Mr A had been seen by his dentist and out-of-hours services and was soon under the care of a consultant. Therefore, we did not uphold the complaint.

Summary

Ms C complained about the care and treatment that her late mother (Mrs A) received at Monklands Hospital. Mrs A was admitted to A&E and was diagnosed with a urine infection. Hospital staff expressed concern over her condition and offered admission to the hospital but Mrs A declined as she thought she only had a urine infection. A week later, as Mrs A's symptoms did not improve, she was seen at home by a doctor. A large mass was identified in her pelvis and there was concern that she may have had a stroke. Mrs A was subsequently admitted to hospital where her stroke diagnosis was confirmed with a scan. Mrs A fell out of bed twice while in the hospital, the second time fracturing her hip which required surgery. After recovering from surgery, she was transferred to another hospital which catered for elderly patients. Mrs A was later discharged and died a few months later.

Ms C complained that Mrs A had not been properly assessed when she was first admitted to A&E and that Mrs A was not given proper rehabilitation support or physiotherapy following her stroke. Ms C was also concerned that the care Mrs A received after her hip fracture was unreasonable. Finally, Ms C complained that communication between the hospital and Mrs A's family was poor.

We took independent advice from a consultant geriatrician, a chartered physiotherapist and a registered nurse. We found that Mrs A's initial assessment had been thorough, and a reasonable diagnosis had been made. We also found that her rehabilitation and physiotherapy had been reasonable but that it had been limited by Mrs A's inability to participate due to her condition. Similarly, her care after she fractured her hip had been appropriate and we found that, although efforts had been made to prevent her fall, it had not been possible to do so. While communication with Mrs A had not always met her and her family's needs, we found that it had been clear and reasonable. For these reasons, we did not uphold Ms C's complaints.

Summary

Ms C complained that the medical practice wrongly provided her with the flu vaccination a number of years ago and that, as a result, she suffered from numerous medical conditions. These included brain damage, multiple sclerosis, uveitis (inflammation in the eye), reactive arthritis and facial disfigurement. Ms C was concerned that she had not been advised of the risks or potential side effects of the vaccination.

We took independent advice from a GP and found that it was appropriate for the practice to have offered Ms C the vaccination as she suffered from asthma. There was nothing in Ms C's medical records that showed she was suffering from any medical conditions which would have prevented her from receiving the flu vaccination. We also noted that Ms C had signed the consent form for the vaccination at the time. In addition, Ms C's later health issues were not recognised as being attributed side effects from the vaccination. Therefore, we did not uphold the complaint.

Summary

Mr C, who works for an advice and support agency, complained to us on behalf of his client (Mrs A) that her GP practice failed to provide her with appropriate medical treatment for a painful shoulder. Mrs A asked the practice to give her a steroid injection as her frozen shoulder was causing her pain and distress but was referred to physiotherapy who would decide whether or not to provide the injection. Mrs A was unhappy as she had been given the steroid injection by the practice the year before.

We took independent advice from a GP and found that the practice had provided a reasonable level of care. Although some practices can administer steroid injections to patients if they have additional training, there is no requirement for them to do so. We found that the practice had acted reasonably by asking Mrs A to attend physiotherapy and that they would determine if it was appropriate to administer a steroid injection. We also found that the practice had acted reasonably by prescribing painkilling medication to Mrs A in order to address her symptoms. Therefore, we did not uphold Mr C's complaint.

Summary

Mr C complained that his dentist had failed to provide him with appropriate dental treatment. In particular Mr C felt that his dentist had taken a radiograph which was not required and that they had tried to promote the use of private dental treatment over NHS treatment.

We took independent advice from an adviser in general dentistry and found that the dentist had acted in accordance with the national guidance for taking radiographs. The radiographs indicated that there was decay present in Mr C's teeth and that the dentist had suggested appropriate treatment to be carried out. The records also contained evidence of discussions between the dentist and Mr C where it was explained what treatment was available on either NHS dental treatment or private dental treatment. There was no evidence to suggest that the dentist had promoted private dental care. Therefore, we did not uphold Mr C's complaint.

Summary

Ms C visited her GP practice a number of times as she had concerns about a loss of appetite and unexplained weight loss. The practice carried out blood tests, and referred Ms C for an x-ray and an ultrasound. When these tests reported as normal, the practice referred Ms C to a gastroenterologist (a doctor specialising in the treatment of conditions affecting the liver, intestine and pancreas). Ms C complained that the practice unreasonably delayed in investigating her weight loss.

We took independent advice from a GP. We found that the practice carried out the relevant tests and referred Ms C to gastroenterology at the appropriate time. The practice acted appropriately and did not delay in investigating Ms C's weight loss. Therefore, we did not uphold this complaint.