Nottingham University Hospitals NHS Trust

9. Mrs Q complains about the care and treatment her late husband, Mr Q, received from the Trust from 14 September 2023 to 2 January 2024. Specifically, she complains there were delays in diagnosing and treating GvHD. Within this, Mrs Q complains:

• there were delays in installing appropriate lines to deliver medication and take blood samples • it took 5-8 days to replace a line which a nurse accidentally cut, so Mr Q did not receive appropriate treatment during this time • the nurses did not check Mr Q had taken medication and left it on his table • there was a delay in arranging tests to investigate brain concerns and lasting damage from a seizure on 7 November 2023 • the Trust did not contact the family when Mr Q suffered a second upper gastrointestinal (GI) bleed • Mr Q was inappropriately placed on his side which affected his oxygen levels • the nurses did not provide appropriate skin care and Mr Q was not moved regularly • treatment was delayed on 11 and 18 December 2023 as platelets were not requested on time • there was a delay in providing white blood cell treatments on 15 December 2023 • there was a week where nutrition was not provided to Mr Q, which weakened him and affected his ability to recover • the urology team did not review Mr Q to identify reasons for a blocked catheter.

10. Mrs Q says the Trust has not commented on the impact of the failings on her husband’s overall outcome. She feels the poor care and delays in treatment affected Mr Q’s ability to recover and compromised his chances of survival. She says her husband might not have died when he did, had his care been appropriate.

11. Mrs Q explains these events have caused significant distress and grief to the family, as they have been left wondering what Mr Q’s outcome might have been had he received appropriate care. She also says her husband’s death has caused considerable financial hardship.

12. Mrs Q is seeking a review of her husband’s care to understand if the failings contributed to his decline and a financial remedy.

13. The law says we cannot investigate a complaint where a person has (or had) the option to take legal action, unless we consider this is (or was) unreasonable in the circumstances. We do not consider whether legal action would succeed but whether it would be a reasonable option to look in to.

14. We also cannot look at complaints if someone has the chance to take legal action that would address the issues in their complaint and potentially give them the outcome they are looking for.

Late diagnosis

15. We note Mrs Q’s concerns about the delayed diagnosis and treatment of GvHD. There were a number of delays throughout Mr Q’s admission, which meant he did not receive timely and regular treatment, appropriate investigations, and nutrition.

16. Mrs Q has explained the significant effect these events have had on her and the family, and the financial pressures she is facing following the death of her husband. It is therefore understandable she is seeking a significant financial remedy to recognise the loss of her husband’s earnings.

17. We consider it would be reasonable for Mrs Q to gain legal advice in relation to these concerns. This is to consider the outcomes she is seeking which are a review of her husband’s care (to understand if the failings contributed to his decline and death), and a consideration of compensation.

Nursing care and communication

18. Mrs Q also complains about the nursing care in relation to medication administration, skin care, and the communication with the family following the second upper GI bleed.

19. These aspects may not be part of a potential legal claim. We have therefore considered whether we should look at these now.

20. At the moment, we think it is best to wait for the outcome of any legal advice and the conclusion of any potential legal action, before we consider these concerns. This is because any legal action may draw in other issues as part of its consideration and provide a response or resolution to these.

21. It is for these reasons that we will not look at these aspects at this time.

Next steps and our time limit

19.If Mrs Q is unhappy following legal action or has outstanding issues or outcomes which she could not pursue via the courts, she can return to us. However, we cannot consider issues which have already been examined by the courts.

20.If for some reason, Mrs Q is unable to proceed down the legal route and wants us to consider her complaint again, she can also contact us. It is important she approach us as soon as possible. This is because we can usually only look at complaints that are raised within 12 months of the individual becoming aware of the issue. However, we can sometimes put the time limit to one side if we see there are good reasons for the delays in a case reaching us.

21.We recognise this has been a significant and distressing complaint for Mrs Q and her family. We cannot underestimate the impact of these events, and we are very sorry for their loss. We hope the above clearly explains the reasons for our decision and the next steps they can take.

1. We have carefully considered Mrs Q’s complaint about Nottingham University Hospitals NHS Trust (the Trust).

2. Mrs Q complains about the care and treatment provided to her late husband, Mr Q.

3. Mr Q had undergone a stem call donor transplant in July 2023, to treat acute myeloid leukaemia (AML – a type of blood cancer which starts from young white bloods cells in the bone marrow).

4. Mrs Q says the Trust missed opportunities to diagnose and treat a known complication of the stem cell transplant, known as graft vs host disease (GvHD). This disease occurs when white blood cells in the donated bone marrow or stem cells attack the cells of the host body.

5. Mrs Q says there were numerous failings and delays in the Trust’s care, and she feels these weakened Mr Q and compromised his survival. She says Mr Q’s death has caused her and her family significant distress and grief. Mrs Q has also been financially impacted due to the loss of her husband’s income at a crucial time in their lives. We are very sorry for Mrs Q’s loss and the lasting impact of these events.

6. We consider there is a possible legal remedy available in relation to the delayed diagnosis and treatment. We would therefore not consider these concerns as the law says we cannot investigate a complaint where a person has the option to take legal action.

7. We understand Mrs Q has some further concerns around nursing care and the information shared with the family. We consider it is best to wait for the conclusion of the legal process before we consider these concerns. This is because the legal action may draw in other issues as part of its consideration and provide a response or resolution to these.

8. Overall, it is for these reasons that we have decided not to consider Mrs Q’s complaint at this time.