University Hospitals Sussex NHS Foundation Trust

3. Mrs H complains about the care and treatment she received from the Trust between the end of July and August. She states it:

· did not follow the correct pathway regarding the monitoring of her pregnancy ‘of unknown location’. As a result, staff did not put appropriate monitoring in place or schedule further blood tests following her discharge on 6 August

· did not advise her of the likelihood that her pregnancy could be ectopic, and the associated risks

· did not refer her directly to the gynaecology department on 10 August.

4. Mrs H says she suffered a significant amount of pain and distress between 6 and 10 August following advice from staff to miscarry naturally at home. She also suffered a significant amount of pain due to her fallopian tube rupturing on 10 August.

5. Mrs H explains the experience has caused tremendous distress to her and her husband. She says their mental health has been heavily impacted, which has caused them both to work reduced hours as they recover. This has caused financial loss to her family.

6. By bringing this complaint to us, Mrs H would like an acknowledgment of wrongdoing, staff to learn from the experience (service improvements) and financial compensation of around £12,000.

7. The Trust scanned Mrs H on 31 July. The result was ‘pregnancy of unknown location’. The Trust followed up this result with a blood test the same day.

8. Mrs H attended A&E at the Trust the following day, as she was experiencing significant abdominal pain. The Trust undertook a further blood test.

9. Mrs H reattended A&E on 2 August and the Trust undertook a day two blood test. Mrs H says a doctor in the gynaecology ward advised her she was having an ‘early uterine miscarriage’ and ‘not to worry’ about a possible ectopic pregnancy.

10. Mrs H returned to A&E on 6 August. The Trust undertook an ultrasound at 9.05am. Mrs H states the result was not double checked with another radiologist. Staff then undertook a day four blood test an hour later. Mrs H explains, due to the pain she was experiencing, staff advised she should pack an overnight bag, ready for admission. Mrs H recalls staff examined her on arrival at the gynaecology ward and advised her she did not need repeat blood tests as it was very unlikely she was having an ectopic pregnancy. Staff advised Mrs H to return home to miscarry naturally.

11. Mrs H returned home and carried on as normal for three days, preparing for a natural miscarriage. She explains the abdominal pain was steadily building but she attributed this to the miscarriage.

12. Mrs H returned to A&E on 10 August as the pain became unbearable. She explains while she was waiting to be seen she nearly passed out and was very sick. The Trust assessed her and admitted her to the gynaecology ward. Staff took a further blood test on admission.

13. She had an ultrasound on 11 August which showed a ‘highly suspicious ectopic pregnancy’.

14. Mrs H had an operation to remove her ruptured right fallopian tube on 12 August.

17. We can consider complaints about organisations working on behalf of the NHS and whether organisations are responsible for failings. However, the law says we cannot investigate a complaint if there is a legal remedy available and it is reasonable for the complainant to pursue it. Based on the information we have, Mrs H has a clinical negligence claim available to her. We consider it reasonable for Mrs H to continue with the process of exploring legal action as she has already started this.

18. The issues Mrs H complains about involve her concerns the Trust followed the wrong pathway regarding the monitoring of her pregnancy, and a lack of proper advice regarding a possible ectopic pregnancy. She states this caused her a significant amount of pain and distress, as well as the rupturing of her fallopian tube. She also complains about the psychological impacts to her and her husband.

19. Mrs H wants financial compensation of around £12,000 as one of the outcomes of her complaint. She may be able to achieve this if the legal claim she is exploring is successful.

20. Mrs H also wants an acknowledgment of wrongdoing and for staff to learn from her experience. It is possible she could achieve both outcomes as a by-product of legal action.

21. We might also consider all of Mrs H’s desired outcomes if she returns to us after exploring legal action, or she is unsuccessful in her legal action. If Mrs H returns to us at either of these points, we would need to consider our time limit.

22. In summary, an alternative legal remedy is available to Mrs H in respect of her complaint about the Trust, and she has started this process. Therefore, we will not be taking any further action at this time. We do not underestimate the impact of the issues Mrs H has raised. We hope we have explained our decision clearly.

1. We have carefully considered Mrs H’s complaint about University Hospitals Sussex NHS Foundation Trust (the Trust). We consider Mrs H should continue pursuing the legal action she is currently in the process of exploring.

2. We are very sorry to hear about Mrs H’s concerns and the distress she experienced. We appreciate this experience continues to be a matter of considerable trauma to Mrs H and her husband. We have considered the complaint and are satisfied the clinical negligence claim she is pursuing is currently the appropriate action for her in the circumstances.