Upheld, no recommendations

Summary

Mrs C was diagnosed with breast cancer in 1998. Due to the severity of the disease and her young age, she was given yearly mammograms (a special

x-ray picture of the breast) which she was told were to continue until she was 50.

Around eleven years after diagnosis, Mrs C moved to Scotland. She was given a mammogram in 2010. The following year, it was explained to her that the policy was for mammograms to be given every two years.

After her routine mammogram in 2012, Mrs C was told she had cancer in her right breast. She alleged that if she had been given a mammogram in 2011 as she had expected, and as she had requested, she would have learned of her condition at an earlier stage and the outcome would have been better for her.

In investigating the complaint, we considered all the available information, including the complaints correspondence and Mrs C's relevant clinical records. We also took independent advice from a medical adviser. The adviser said that there was a difference between screening and follow-up treatment.

Mrs C was being followed-up after illness and treatment. In the adviser's view, Mrs C should have continued having annual follow-ups until she was 50. She also said that Mrs C was in a special category as she also had a family history of breast cancer. The adviser did not consider that Mrs C's personal circumstances were taken into account when she was being treated. She noted, however, that the hospital's policy of two year mammograms met minimum required standards, and that annual mammograms from the age of 30 to 50 would be an extreme risk. The adviser said that she would have offered MRI scans rather than mammography. We upheld the complaint but, because of this advice, made no recommendations.

Summary

Mr C was cited as a witness in a trial. He attended court on that date, only to be told that his attendance was not necessary as the accused had pled guilty. Mr C complained to the Crown Office and Procurator Fiscal Service (COPFS) that, because he was not told that his attendance was no longer required, he had suffered financial loss and unnecessary upset, anxiety and inconvenience.

COPFS explained that this had happened because there were administrative errors in their process for advising witnesses that they need not attend court. They apologised to Mr C for this and invited him to submit an expenses claim, which they paid as they would have, had the trial gone ahead.

In relation to the upset and inconvenience caused, COPFS advised Mr C that such concerns are addressed through witness support services such as Victim Support Scotland and their witness service, but that they do not provide compensation for upset, anxiety or inconvenience. Given that COPFS accepted that administrative errors on their part had led to Mr C attending court unnecessarily we upheld his complaint, but as they had already taken action to address what had gone wrong, we did not find it necessary to make any recommendations.

Summary

Mr C complained that a councillor made inaccurate statements at a planning committee hearing, which caused the committee to reject Mr C's application. He also complained that when he raised his concerns with the council they failed to carry out a reasonable or prompt investigation into his complaint.

As Mr C appealed the decision to reject the application, and was successful, and as he had the ability to make a claim for fees at his appeal, we explained that we could not look at the councillor's comments. We examined the council's investigation into his complaint and established that it was reasonable. However, as it took substantially longer to conclude than it should have done, and as the council failed to keep Mr C updated on progress, we upheld his complaint about the investigation, although we did not find it necessary to make any recommendations.

Summary

Mr C's daughter (Miss A) who was three years old, was taken to her medical practice because she was vomiting. Mr C complained that GPs there failed to appropriately investigate Miss A's symptoms and that this led to a delayed diagnosis of a brain tumour. Miss A's parents had taken her back three days after the first visit, and further vomiting was reported. The GP recorded that a referral to a paediatrician should be considered if the current pattern of vomiting continued. Miss A's parents brought her to the practice again three months later. It was recorded that she had a viral infection and that she had had a few episodes of vomiting. She returned to the practice again nearly eight weeks later. It was recorded that the vomiting had continued for a number of months and that she vomited approximately every two weeks. The GP prescribed medication for stomach problems.

Miss A was taken to the practice again ten days later, which was her fifth visit about vomiting. It was recorded that she was vomiting as before and this had been for a few months on and off. She was prescribed further medication. It was recorded that her parents should call the practice if this was not working and she would then be referred to a paediatrician. Two weeks later, Miss A was referred to a paediatrician in view of the unexplained vomiting. This was noted as a routine (not an urgent) referral.

Miss A attended the practice again two weeks later, before she had seen a paediatrician. It was recorded that the vomiting was on-going and that she had been tired lately and had a bradycardia (slow heart rate) when lying down. A referral was made to a private paediatrician, as her parents had private health insurance. Mr C's wife phoned the practice later that afternoon, however, as Miss A's condition had worsened and she was now more drowsy. It was arranged that Miss A would be taken to hospital for assessment, where she was admitted. The next day, another hospital phoned the practice to tell them Miss A had been admitted there, as she had a brain tumour that required urgent neurosurgery.

Our investigation found that the practice carried out a significant event analysis to assess why their GPs did not refer Miss A for a specialist opinion earlier. They considered the National Institute for Health and Care Excellence (NICE) referral guidelines for suspected cancer, which say that when a child presents with the same symptoms several times, but there is no clear diagnosis, they should be referred to hospital urgently. The practice acknowledged that under these guidelines Miss A's referral could have been made earlier, as an urgent case. In addition, the GP who saw Miss A at her second visit had recorded that referral to a paediatrician should be considered if the current pattern of vomiting continued. Despite the fact that Miss A did continue to vomit and attended the practice a further three times, she was not initially referred to a paediatrician. When the referral was eventually done, it was marked as routine rather than urgent. This was a balanced decision, but having carefully considered the matter, we upheld Mr C's complaint. In view of the action taken by the practice as part of the significant event analysis, however, we did not find it necessary to make any recommendations.

Summary
Ms C complained that her dentist failed to provide appropriate treatment over a two year period. She had raised repeated concerns about pain and sensitivity in her teeth and asked the dentist to take x-rays. The dentist said that this was not required as x-rays had been taken two years previously. She put Ms C's sensitivity down to gingivitis and gum recession.

Ms C sought a second opinion from another dentist. X-rays were taken and showed that she had an abscess and tooth decay. She complained that her own dentist should have diagnosed this.

We found that there was a difference of opinion between Ms C and the dentist as to what information she had provided about her symptoms. The dentist's examination was suitable for a complaint of sensitivity, but not for a complaint of severe pain as described by Ms C. We were compelled, however, by the fact that Ms C sought a second opinion straight after one of her appointments and was found to have a well-developed abscess. We concluded that, on the balance of probabilities, Ms C provided details of her symptoms and the dentist should have taken diagnostic x-rays.