Blackpool Teaching Hospitals NHS Foundation Trust

5. Mrs B attended the Trust in November 2019 to have a hysterectomy (an operation to remove part or all of the womb). Mrs B says Trust staff did not ask for her consent for a junior doctor to give her spinal anaesthetic. She says the junior doctor had not done this procedure before and she believes something went wrong to cause her new health issues.

6. Mrs B says that, since she had the spinal anaesthetic, she has had frequent non-epileptic seizures. She had not previously had any seizures. She says the seizures are distressing and frightening as she is conscious but unable to move or speak.

7. Mrs B was readmitted to the Trust two days after her operation with multiple seizures. Mrs B says a ward nurse tried to bring her out of one seizure by pressing hard on her collarbone (the bone between the shoulder and the neck). Mrs B says the nurse pressed so hard she caused significant pain and bruising.

8. Mrs B says that, for a month after her discharge from hospital, she could not be left alone until an alarm system and keysafe (a small box you can lock or unlock by entering a code on a dial or keypad) were installed in her home. Her husband, who is self-employed, lost earnings to care for her during this time. Mrs B has lost her driving licence for medical reasons and has been unable to return to work, so she has lost both her independence and earnings.

9. Mrs B wants to know if the spinal anaesthetic caused the non-epileptic seizures. She wants to know if the junior doctor made a mistake when giving the spinal anaesthetic. She would like financial compensation for the distress her non-epileptic seizures and loss of earnings have caused.

10. Mrs B attended the Trust in November 2019 to have a hysterectomy. A junior doctor gave her a spinal anaesthetic under the supervision of a consultant anaesthetist. Mrs B says she felt intense pain when the doctor gave her the anaesthetic and she shot forward on the operating table.

11. When Mrs B woke up after the operation, a nurse told her that she was staring blankly and not responding. Mrs B did not recall this. She stayed overnight and was discharged the following evening.

12. Two days after the procedure, Mrs B woke up and had a seizure in which she lost consciousness, and several more seizures. She did not recall the seizures, but her partner witnessed them. Mrs B was taken to hospital where she continued to have multiple seizures. Mrs B stayed in hospital for five days.

13. A neurologist ran some tests on Mrs B and diagnosed non-epileptic seizures. There is no treatment for seizures like this. They continue to happen to Mrs B without warning, although not as often as before. Mrs B believes the spinal anaesthetic caused the seizures and thinks something went wrong when she was given the anaesthetic.

The spinal anaesthetic

17. Mrs B said she felt intense pain and tingling when she got the spinal anaesthetic. Because of this, she thinks something went wrong when the spinal anaesthetic was given.

18. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any signs that something went wrong.

19. The Royal College of Anaesthetists sets standards for anaesthetists in UK healthcare settings. It provides patient information leaflets relating to different anaesthetic procedures and their risks.

• The Royal College of Anaesthetists ‘Your spinal anaesthetic’ explains that patients may feel pins and needles or a sharp pain in one of their legs during the spinal injection. It says it can take up to four hours for sensation to fully return, and the patient may feel some tingling during this time. It describes some common side effects, including pain during the injection, which may be because the needle touches a nerve. It says spinal anaesthesia rarely causes nerve damage.

• The Royal College of Anaesthetists ‘Risks associated with your anaesthetic’ states that symptoms of nerve damage may include pins and needles, muscle weakness and paralysis (when you cannot move a part or all of your body). The symptoms of nerve damage from a spinal anaesthetic do not include non-epileptic seizures or seizures caused by mental or emotional processes.

20. Our adviser explains pain and tingling is a common side effect of this type of anaesthesia. It happens when the needle gets close to a nerve when the doctor injects the anaesthetic. It is a common response to spinal injections and has no long-lasting consequences for Mrs B. There are no known links between spinal anaesthetics and non epileptic seizures, and there is no evidence the spinal anaesthetic injection caused Mrs B’s seizures. It is understandable that, as the seizures only started happening after Mrs B’s operation, she thought something may have gone wrong.

21. The Trust's response matches the information in Mrs B’s healthcare records, and its explanations are in line with the Royal College of Anaesthetics standards. We saw that the anaesthetic records contain no notes about problems arising during this procedure. We have seen no signs that anything went wrong during the spinal anaesthetic procedure. We found no known links between this procedure and the seizures Mrs B experienced after her operation. We cannot link the events Mrs B complains about with the seizures Mrs B says she has had.

Consent

22. While there are standards relating to consent, there are no specific standards relating to getting consent for trainee doctors to perform medical procedures. The GMC’s ‘Good medical practice’ states that doctors must make sure all staff they manage are supervised appropriately. In this case, the trainee doctor gave Mrs B the spinal anaesthetic injection under the consultant’s supervision, which meets these standards.

The ward nurse

23. Mrs B also complained about the nurse’s actions on the ward during one of her seizures. She says the nurse pressed too hard on her collarbone to bring her out of the seizure, causing pain and bruising. Mrs B wants to know what the Trust has done about the nurse she complained about. We looked at the Trust’s response to this complaint.

24. Once we have looked at whether anything went wrong, we look at whether there are signs the event complained about had a negative effect and what the organisation has done to put things right. Having done so, we are satisfied the Trust has already done enough to put right the impact of these events.

25. The Trust accepted that the nurse used inappropriate pressure when she pressed on Mrs B’s collarbone to bring her out of the seizure. In response, the Trust dealt with the nurse directly by reflecting on what had happened, recording a conversation and providing more training, in line with its disciplinary policy.

26. Our Principles of Good Administration say that when mistakes happen, organisations should accept them, apologise and put things right quickly and effectively. The Trust has taken responsibility for what the nurse did and has apologised for it. Our Principles for Remedy say that where poor service has affected someone, the organisation should put things right, including by providing more training or supervising staff. The Trust’s actions were in line with our principles.

27. We think the Trust took this complaint issue seriously and responded appropriately to what happened on the ward. Data protection law in the UK means that the Trust does not need to share details of disciplinary actions taken against its staff. But we believe the Trust has responded fairly and shared what information it could with Mrs B about how it has responded.

28. We recognise that Mrs B may be disappointed with our decision. We understand that experiencing these seizures and the lifestyle changes Mrs B has had to make to cope with them have been very distressing to her. We hope our explanations reassure Mrs B that the spinal anaesthetic did not cause them.

1. The Parliamentary and Health Service Ombudsman has carefully considered Mrs B’s complaint about Blackpool Teaching Hospitals NHS Foundation Trust (the Trust).

2. We have seen no sign that anything went wrong with the process of giving Mrs B her spinal anaesthetic (so she could not feel anything in her spine), and consent (permission) for the anaesthesia was given in line with relevant standards.

3. In relation to the actions taken regarding the complaint about the ward nurse, we are satisfied the Trust has done enough to put right the impact of this event on Mrs B.

4. We recognise that Mrs B has had a difficult and distressing experience with non epileptic seizures (very sudden attacks of an illness other than epilepsy in which someone loses consciousness or develops violent movements). We hope our explanations reassure Mrs B that the spinal anaesthetic did not cause the seizures.