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North Bristol NHS Trust

P-002906 · Statement · Decision date: 28 August 2024 · View Bristol NHS Trust scorecard
Drugs / medication Choice and Consent Surgery Communication Access High-risk medication monitoring
Complaint (AI summary)
Mr U alleged the Trust failed to administer blood thinners to his wife, leading to a fatal blood clot, and also cited issues with consent, surgery delays, and communication.
Outcome (AI summary)
The ombudsman closed the case without investigation, as the complaint was submitted outside the time limit and no reason to waive it was found.

Full decision details

The Complaint

3. Mr U complains the Trust did not give his wife (Mrs U) blood thinners over a four-day period in May 2020 and did not explain why or record a reason for this.

4. He says the Trust’s actions meant his wife developed a blood clot which led to her death.

5. Mr U also complains the Trust: • did not consult him as his wife’s carer when seeking her consent ahead of a series of procedures between 10 and 15 May 2020 • delayed an operation to remove a mass several times • did not communicate with him during his wife’s time in hospital, and • stopped him seeing his wife during her final moments.

6. He says this further reduced the chance of her survival and caused him avoidable distress at an exceptionally upsetting time.

7. Mr U says he would like financial compensation.

Background

8. Mrs U was experiencing stomach pains and dehydration in May 2020 so visited her GP. The GP referred her to hospital and the Trust admitted her as an emergency. It gave her blood thinners on admission to prevent her developing a blood clot.

9. The Trust planned to do an internal investigation using a camera on the following day. It therefore decided to pause giving Mrs U the blood thinners. The Trust postponed the investigation several times but continued withholding her blood thinners. The investigation eventually happened on 15 May and the Trust resumed her blood thinners afterwards.

10. On 17 May Mrs U’s health worsened and she had a cardiac arrest. This is when someone’s heart stops working. Staff resuscitated Mrs U and transferred her to the intensive care unit. Unfortunately, Mrs U had another cardiac arrest early the following day and sadly died. The Trust told Mr U a blood clot in his wife’s lungs (pulmonary embolism) was the cause of her death.

Findings

12. The law says a person needs to complain to us within a year of becoming aware of the problem. We cannot investigate complaints brought to us after one year, unless there is a good reason to do so.

13. We have discussed the reasons for Mr U’s delay with him to understand why he did not come to us sooner. We have also considered how long the Trust took to investigate what happened.

14. The problems set out above happened in May 2020. In July a senior member of the Trust contacted Mr U. They explained they had done so under the Duty of Candour. This is an obligation healthcare organisations have to tell patients and their loved ones when things might have gone wrong.

15. They told Mr U the Trust was investigating how it cared for his wife as it had identified an ‘incident’ to do with withholding her blood thinners. Mr U also raised concerns about consent, delays to an operation and communication during his conversations with the Trust.

16. The Trust wrote to Mr U on 6 August. It confirmed its investigation would look at the administration of blood thinners, as well as the other problems he had raised.

17. As it was Mr U who raised concerns about the other issues, we consider he knew about them when they happened. However, we accept Mr U only became concerned things went wrong with his wife’s blood thinners after the Duty of Candour conversations with the Trust.

18. Therefore, Mr U has two different dates of knowledge for the problems he has brought to us. These are May and July 2020. For his complaint to have been in time we should have received it by May and July 2021.

19. Mr U first approached us with his complaint on 25 September 2023. We needed to be sure he had complained to the Trust first and asked him to send us its final response to his complaint. We closed his complaint on 3 November whilst we waited for the necessary information. Mr U provided it the following day.

20. Therefore, we consider Mr U first properly referred his complaint to us on 4 November 2023 when he sent us the Trust’s final response.

21. As it took Mr U over three years to bring his complaint to us we have considered the reasons for this delay.

22. Mr U explained the Trust took some time to investigate what happened. He also pursued legal action to try and resolve his complaint. We have looked at these reasons in more detail.

23. The Trust started its investigation of what happened in July 2020. It published its findings in October and referred Mr U to us if he remained unhappy.

24. It was reasonable Mr U waited for the Trust to finish its investigation before he approached us. This is because the local complaints process is often the quickest and easiest way to resolve problems. Further, the Trust’s complaint response contained important information informing Mr U about our service.

25. We have therefore set aside this three-month period. Had Mr U brought his complaint to us promptly following the Trust’s complaint response, it would have been within our 12month time limit.

26. However, instead of approaching us with his complaint Mr U took legal action. A solicitor accepted the case and got some expert clinical advice on what happened.

27. The adviser explained there were so many potential causes for Mrs U’s pulmonary embolism and eventual death they were unlikely to find the Trust’s actions were to blame. As a result, the solicitor stopped pursuing the case.

28. Mr U disagreed with this decision and said the adviser was not an expert on the details of his wife’s underlying health condition. Mr U says the solicitor took three years to reach their view and is the reason he took so long to come to us.

29. Mr U also explained he is unhappy the solicitors did not consider all the problems he raised. He says they did not look at how the Trust communicated with him and did not hold anyone to account for what he believes was his wife’s untimely death.

30. We acknowledge Mr U attempted to resolve his complaint through the legal route, and he blames this for the long delay. We have asked Mr U to provide evidence of when he approached the solicitor, and when they shared their decision with him. We have also asked him to demonstrate what he did to minimise how long he was waiting for the outcome.

31. Despite asking Mr U to provide this information he has unfortunately not done so. This means we do not know how long he waited before approaching a solicitor, what they agreed to look at or if he could have come to us sooner following their decision.

32. However, even if this evidence becomes available it would unlikely change our view.

33. The legal route is one option to resolve a complaint about the NHS. It could reasonably have achieved the outcome Mr U wants. However, there is a choice between taking that route or pursuing the complaint with us. In this instance Mr U attempted to take legal action and it was unfortunately unsuccessful for him.

34. Nevertheless, this is not a sufficient reason for us to set the time limit aside. The Trust’s complaint response clearly directed Mr U to us if he remained unhappy. Approaching us at that point would have been a reasonable course of action. Instead, it took him threeyears to do so.

35. Mr U actively selected one option with the knowledge we could also have considered his complaint. The fact he pursued this demonstrates there were no barriers to him approaching us as the Trust advised.

36. Although we are unable to look at Mr U’s complaint we understand how devastating the events have been for him and recognise the distress he has experienced. Whilst this is not the outcome he was hoping for, we hope we have clearly explained the reasons for our decision.

Our Decision

1. We have carefully considered Mr U’s complaint about the North Bristol NHS Trust (the Trust). We understand the death of Mr U’s wife has been exceptionally upsetting for him and the sad circumstances he has told us about only make this worse.

2. Mr U’s complaint falls outside of our time limit and we consider there is no persuasive reason for us to put it aside and consider the complaint further.

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