SPSO Individual Decisions

Mr C complained on behalf of his partner (Ms A) who had been diagnosed with lung cancer. She also suffered from other illnesses. Ms A had experienced shortness of breath and fatigue. It was established that she had anaemia and was referred to St John's Hospital for a blood transfusion by the oncology team at another hospital. When Ms A arrived at St John's Hospital there were no beds and before being transferred to the Medical Assessment Unit (MAU) she spent seven hours on a temporary bed in the corridor. She was eventually transferred to MAU and was given a blood transfusion later that night. Later, she was moved to an observation ward and the next day she was discharged home. A few days later, Ms A was unwell again and she was admitted to St John's Hospital once more. Again, she spent a number of hours in a corridor before being admitted to the MAU. Mr C complained that these events were unacceptable given Ms A's serious illness. The board recognised that the situation had not been ideal but said that on both occasions the hospital had been extremely busy. They apologised but said that they could not give assurances that the same situation would not occur again. They confirmed that Ms A had been treated in accordance with the cancer treatment helpline advice. They added that St John's Hospital had asked the referring hospital whether the transfusion could be deferred the first time Ms A attended hospital but were told that it could not. We took independent advice from consultants in general medicine and oncology (cancer). We found that although the board had no control over the number of patients arriving at the same time, it was, nevertheless, unreasonable that a cancer patient like Ms A should have had to wait so long (seven hours each time) before being transferred to MAU. We also found that there was no clinical reason why Ms A should have been given a blood transfusion late at night. For these reasons we upheld the complaint. Although Mr C had

Mr C complained that the board had failed to provide a reasonable standard of psychiatric (the branch of medicine that deals with mental illness) care and treatment to his wife (Mrs A) before her death. Mrs A had been diagnosed with a brain tumour. The psychiatrist responsible for her care considered that she had a depressive illness, but Mrs A's family disagreed with this. Mr C also complained about the comments the psychiatrist made at a consultation. We took independent advice from a consultant psychiatrist. We found that the psychiatric care and treatment provided to Mrs A had been reasonable. However, we considered that some of the language the psychiatrist used was unhelpful and left the family feeling criticised. We considered this had been unreasonable and upheld this aspect of Mr C's complaint. Mr C also complained that the board failed to handle his complaint reasonably. We found that although Mr C had clearly expressed dissatisfaction in an email, the board had failed to record this as a complaint or to contact Mr C for clarification. When Mr C subsequently made a further complaint, the board then delayed in responding to this. Therefore, we also upheld this aspect of Mr C's complaint.

Mrs C complained about the treatment she received from the practice for an infection in her leg. Mrs C attended an out-of-hours surgery over the weekend prior to attending her local practice on the Monday. The practice adjusted Mrs C's medications and arranged a follow-up appointment with a nurse for wound dressing. Mrs C's leg grew worse and a GP was called to her home. The GP arranged for Mrs C's admission and further assessment at a hospital. We took independent medical advice from a GP. We found that Mrs C's treatment by the practice was reasonable and found no failings in the treatment offered. Therefore, we did not uphold Mrs C's complaint. Related reading View Decision Report 201803525 as a PDF (23.65 KB) Updated: June 19, 2019

Mr C complained about the care and treatment he received at the Royal Infirmary of Edinburgh. He attended A&E after experiencing pain in his back and leg. Mr C was assessed by the on-call orthopaedic (conditions involving the muscoskeletal system) doctor and an x-ray was performed. Following this, Mr C was admitted to an orthopaedic ward. He was then discharged four days following admission. Weeks later, Mr C returned to hospital and a hip x-ray was performed. Investigations over the following days identified that Mr C had a pathological hip fracture and advanced prostate cancer. Mr C underwent a hip replacement procedure and was referred to the uro-oncology (the diagnosis and treatments of tumors of urinary systems) service. Mr C complained about the delay in accurately diagnosing his condition and that he was unreasonably discharged from hospital during the first admission. We took independent advice from a consultant orthopaedic surgeon. We were critical that the board were unable to provide the in-patient orthopaedic notes for Mr C's first admission, other than the summary of ward rounds. We found that the investigations performed following Mr C's initial presentation to the board were inadequate. We found that a hip examination and hip x-ray should have been performed given the examination findings. We considered it was likely that the failings in this case led to a delay for hip replacement surgery, during which time Mr C continued to suffer pain from the condition. We upheld this aspect of Mr C's complaint. In the absence of the orthopaedic records for the first in-patient admission, we noted that the board were unable to demonstrate that Mr C had been safely discharged. We concluded that the decision to discharge Mr C was unreasonable and we upheld this complaint.

Miss C complained about the treatment she received from her dentist. She said that she had presented with a small chip on a tooth and that the dentist had put on a small filling which repeatedly fell off. Miss C said that at the time of the filling the dentist ground the tooth down with an implement. Miss C said that when the filling fell out she was left with an unsightly tooth and she continually had to pay for the filling to be replaced. We took independent advice from a dentist. We found that there was no evidence that the treatment provided was inappropriate or that it was the cause of the filling repeatedly falling out. The records indicated that the dentist had listened to Miss C's concerns about the tooth and explained the potential treatment options. We considered that the problems Miss C reported to the dentist were likely to have been caused by natural wear and tear and that it was appropriate to have offered her the different treatment options. We did not uphold the complaint. Related reading View Decision Report 201805548 as a PDF (23.76 KB) Updated: May 22, 2019

Mrs C complained about the care and treatment provided to her late mother (Ms A) at the Royal Infirmary of Edinburgh. Ms A had undergone treatment for early stage lung cancer, and was followed up at six-monthly intervals. Mrs C complained that at a follow-up appointment, Ms A had been told there were no signs of cancer, but a few weeks later was found to have liver cancer. Mrs C said that there was a failure to identify the spread of lung cancer and that Ms A had been given false hope. We took independent advice from a radiologist (a doctor who specialises in diagnosing and treating disease and injury through the use of medical imaging techniques such as x-rays and other scans) and an oncologist (a doctor who specialises in the diagnosis and treatment of cancer). We found that there had been a failure to identify a mass near Ms A's spine on a scan, and that this was unreasonable. However, we noted that it was unlikely that earlier identification of this would have altered Ms A's outcome. We also found that at a follow-up appointment, the clinical examination done was incomplete as it did not include examination of the abdomen. We upheld this complaint.

Mr C complained about the care and treatment his daughter (Ms A) received from the practice. Ms A contacted the practice about severe abdominal pain and was given advice over the phone. Four days later Ms A was admitted to hospital where she had her appendix and part of her bowel removed. Mr C felt that it was unreasonable that the practice did not examine Ms A in person when she called them and that this failure could have led to a potentially serious situation. We took independent advice from a medical adviser. We found that the practice failed unreasonably to adequately assess and examine Ms A. Therefore, we upheld Mr C's complaint.

Ms C complained that the board unreasonably failed to discover an object left in her nasal tissue after surgery at St. John's Hospital. Ms C said that on removal of stents (splints placed temporarily inside a duct, canal, or blood vessel to aid healing or relieve an obstruction), one stent came away in two pieces. Ms C was alerted at the time that a piece of silicone stent may have been retained. Ms C continued to attend the hospital for treatment of chronic rhinosinusitis (a condition where the cavities around nasal passages (sinuses) become inflamed and swollen for a prolonged period). Sixteen months after the surgery, a scan was carried out which identified that a titanium clip had been retained in the nasal tissue. The silicone stent and titanium clip were removed at the same time Ms C was undergoing another surgery, approximately 12 months after the retained titanium clip was discovered. We took independent medical advice from a consultant rhinologist (a specialist in conditions affecting the nose). We found that the board unreasonably failed to discover and report on all elements retained in Ms C's nasal tissue after surgery. No investigations were carried out until the scan 16 months after the stents were removed, where it was found that the titanium clip was still in place. After it was discovered, it was over a year before it was removed. We found that there was an unreasonable delay in identifying the retained titanium clip. Therefore, we upheld this part of Ms C's complaint. Ms C also complained that the board failed to provide a reasonable explanation as to how an object was left in her nasal tissue after surgery. The board accepted that they had not provided a reasonable explanation. The communication regarding this issue was poor. When it was found that a titanium clip had been retained as well as the silicone stent, it was over four months before Ms C was informed of this. No explanation was provided as to why the clip was retained or w

Ms C complained that her father (Mr A) was inappropriately discharged from the Royal Infirmary of Edinburgh. Mr A had poor balance and mobility and had expressed his concerns about his ability to cope at home. Mr A fell shortly after discharge. After a number of hours, he managed to get help and was taken back to the hospital. Mr A was kept in hospital for another month due to a suspected infection. We took independent advice from a nurse and a clinical adviser. We found that there had been a lack of discharge planning as to whether or not Mr A could safely cope at home and whether he required the assistance of carers or someone to stay with him. We also found that there were signs in the medical records which may have indicated that Mr A may have had an infection prior to discharge and that the signs were not acted upon. We upheld Ms C's complaint.

Mr C, an MSP, complained on behalf of his constituent (Mrs A) about the decision taken by the board not to offer Mrs A surgery to her wrist. Mr C said that the board had not reached the decision based on full information. We took independent advice from a consultant plastic and hand surgeon (a surgeon who repairs or reconstructs missing or damaged tissue and skin). We found that the decision not to offer surgery was reasonable and had been made by a number of experienced surgeons together in a mutlidisciplinary setting. Therefore, we did not uphold the complaint. Related reading View Decision Report 201707407 as a PDF (23.6 KB) Updated: April 17, 2019

Mrs C complained that the board unreasonably delayed in diagnosing secondary breast cancer. Following treatment for breast cancer, Mrs C underwent annual check-ups with a consultant surgeon where she complained of a lump and pain near her reconstructed breast (a breast that has been reshaped following a mastectomy (breast removal)). Mrs C said that these reports were not appropriately investigated. We took independent advice from a specialist in breast cancer. We found that investigations were carried out when Mrs C first reported a lump near the reconstruction and that relevant guidelines did not recommend routine mammography (x-ray of the breast) of the reconstructed site and associated axilla (underarm). We considered that the board had practised within the national recommendations and Mrs C was followed up and examined regularly. We also found that when Mrs C presented with a new lump it was investigated and treated in a timely manner. We found that the standard of medical care was reasonable and there had not been an unreasonable delay in diagnosing the recurring cancer. We did not uphold the complaint. Related reading View Decision Report 201803163 as a PDF (23.87 KB) Updated: March 20, 2019

Mr C complained that his wife (Mrs A) had undergone open heart surgery at Edinburgh Royal Infirmary when she had been due to undergo a less invasive procedure. Following surgery, Mrs A was transferred to another hospital where she died shortly afterwards. Mr C said that his wife suffered from dementia and could not have understood the decision to change the procedure or have provided informed consent. Mr C noted he had welfare power of attorney and accompanied his wife to all her appointments. Mr C said that he had not been informed about the change of procedure. Mr C also complained that Mrs A was unreasonably discharged to another hospital. Mr C felt that Mrs A would have survived if she had been treated differently. We took independent medical advice from a consultant cardiothoracic surgeon (a specialist who operates on the heart, lungs and other chest organs). We found that Mrs A's procedure was changed after an appropriate assessment of the risks of both types of surgical procedure and that it was reasonable to proceed with open heart surgery. There was no evidence that Mrs A's chances of survival were compromised by this decision. We also found that an assessment had been carried out which found that Mrs A had a mild memory impairment, however, medical staff were satisfied that she had the capacity to understand and consent to the change in procedure. We considered that this was reasonable. Therefore, we did not uphold these aspects of Mr C's complaint. In relation to the hospital transfer, we found that this was unreasonable given Mrs  A's condition. We upheld this aspect of Mr C's complaint. However, we could not determine that Mrs A would have survived if this had not taken place. In relation to the board's communication with Mr C and his family, we found that Mrs A had been in hospital for over a week prior to the procedure due to a chest infection and that Mr C had been present every day. We considered that the board should have discussed Mr

Mr C complained about the care provided to his wife (Ms A) during a home birth, in particular that two midwives did not attend at the same time. We took independent advice from a midwife. We found that it was standard practice for one midwife to attend first and that the role of the second midwife is to assist in the event of an emergency requiring one-to-one care. We considered that there was no requirement for emergency care for either Ms A or their child, and therefore, no requirement for a second midwife to be present. We did not uphold this aspect of Mr C's complaint. In the days after the birth, community midwives attended Mr C's home and following an incident, the board decided not to allow any further visits to Mr C's home if he was present. Mr C complained that this decision was unreasonable. We found that the board's actions had been appropriate and the decision taken was reasonable based on the available information. Therefore, we did not uphold this aspect of Mr C's complaint. However, we considered that a further risk assessment should be undertaken in the event of any future pregnancies, to review the requirement for the restriction to remain in place, and we fed this back to the board. Related reading View Decision Report 201701267 as a PDF (23.89 KB) Updated: March 20, 2019

Ms C complained that the board's response to her complaint was unreasonable and contained many errors. We found that the board's response was an accurate reflection of their records of Ms C's treatment. The board explained why they could not delete entries from Ms C's medical records, and added Ms C's handwritten note to the records to reflect her view of events. The board acknowledged that they could have provided Ms C with better information and support to make informed choices about ongoing treatment, and said they were sorry for this. Ms C chose to get private treatment as she was unhappy with the treatment she had received from the board and wanted the board to pay for this. The board offered Ms C different treatment options and consultations with different doctors but Ms C declined this offer. The board's response explained why, under the circumstances, they could not pay for Ms C's private treatment. We considered that the board's response to Ms C was reasonable. Therefore, we did not uphold the complaint. Related reading View Decision Report 201800737 as a PDF (23.78 KB) Updated: March 20, 2019

Mrs C complained about the out-of-hours care provided to her father (Mr A). Mr  A was seen at home by out-of-hours GPs and had been undergoing treatment for constipation in the days prior to this. The GPs considered that Mr A's reported symptoms were related to constipation. Mr A was later admitted to hospital where a catheter was fitted to drain retained urine from his bladder. Mrs C complained that the out-of-hours GPs had missed Mr A's urinary retention and prescribed inappropriate treatment as a result. The board acknowledged that an enema (a  procedure in which liquid or gas is injected into the rectum) that Mr A was prescribed was not appropriate and was unlikely to have been of any benefit in his case. This matter had been taken forwards with staff for reflection and learning. We took independent advice from a GP. We found that there had been no indication that Mr A was suffering from urinary retention at the time he was seen and that the approach taken at the second out-of-hours visit was reasonable. However, we found that an enema had been inappropriate in Mr A's case and that a rectal examination should have been carried out during the first visit. On balance, we upheld Mrs C's complaint.

Miss C complained about the antenatal care and treatment she received when she was pregnant with her child (Baby A). Miss C also complained that the board did not communicate reasonably with her about her antenatal care and treatment. At Miss C's 20 week anomaly scan it was identified that Baby A was measuring larger than expected. Baby A was born prematurely with severe and complex needs and died a few days later. We took independent advice from a midwifery adviser and a sonography (the medical diagnostic imaging technique used to see internal organs, muscles, etc) adviser. We found that No alternative arrangements were made for bloods to be obtained as requested by Miss C's GP during one of her antenatal appointments. There were no records of: one of Miss C's antenatal appointments discussions that the midwife had with the sonographer and the consultant obstetrician (a doctor who specialises in pregnancy and childbirth) the management plan, reason for changing the management plan and the details of what was communicated to Miss C. The reason for not repeating the anomaly scan and requesting a growth scan instead was not explained to Miss C. The sonographer did not seek medical advice regarding Baby A's measurements at the time of Miss C's 20 week scan or as soon as reasonably practicable. The board identified that inappropriate comments were made to Miss C about Baby A's size. The sonographer did not communicate Baby A's measurements to Miss C at the time of her 20 week anomaly scan. Therefore, we upheld Miss C's complaints. We noted that the board had already apologised for some of these failings and had taken action to prevent these reoccurring. We asked the board for evidence of these actions and made further recommendations. Miss C also complained that the board failed to handle her complaint reasonably. We found that the board did not inform Miss C at the earliest opportunity that a Significant Adverse Events Review would result in a delay in respondin

Mr C complained that the board failed to ensure their mental health service for children and young people (CAMHS) provided a reasonable standard of care and treatment. Mr C said that he had a diagnosis of autistic spectrum disorder (a  developmental disability that affects how a person communicates with, and relates to, other people) from CAMHS but that they failed to explore potential mental health conditions during the period in question or provide appropriate treatment. We took independent advice from a specialist in the services provided by CAMHS practitioners. We found that in many respects the CAMHS practitioners who assessed Mr C provided a reasonable standard of care and treatment in relation to diagnosis, management and referrals. We also took into account that it appeared Mr C refused to meet with senior staff to discuss his concerns. However, we found that Mr C's case was complex and he experienced considerable difficulties which had a significant impact on him. We also found that there were missed opportunities to engage with Mr C and to consider further referrals to ensure his mental health needs were met. Therefore, we upheld Mr  C's complaint.

Mrs C complained about the care and treatment that was provided to her late father (Mr A) by the practice on two occasions. Mr A was initially suffering with urinary problems and later, with symptoms of heart failure. Mrs C was concerned that there had been a failure to identify urinary retention as the cause of his symptoms and that, when he was seen by a GP registrar (trainee GP), a few months later, they attributed a seizure-like episode to medication changes, when he was actually suffering from aspiration pneumonia (a complication of pulmonary aspiration. Pulmonary aspiration is when you inhale food, stomach acid, or saliva into your lungs). We took independent advice from a GP. We found that there had been no unreasonable failure to diagnose urinary retention and that Mr A's symptoms were more consistent with urinary infection when he was seen by the practice. Therefore, we did not uphold this aspect of Mrs C's complaint. We found that, when Mr A was seen by the GP registrar, the relevant guidance for diagnosis of heart failure had not been followed. We found that it was not possible to rule out the medication changes as a cause of the seizure-like episode and there was no indication in the medical records that Mr A was suffering from aspiration pneumonia at the time he was seen by the GP registrar. We upheld this aspect of Mrs C's complaint as the issue around diagnosis of heart failure had not been identified as a training issue for the GP registrar.

Mr C had been diagnosed with autistic spectrum disorder (a developmental disability that affects how a person communicates with, and relates to, other people) by the board's mental health service for children and young people (CAMHS). Shortly after discharge from CAMHS, Mr C attended A&E at St John's Hospital when he was in crisis. He was assessed by a psychiatrist (a medical practitioner who specialises in the diagnosis and treatment of mental illness) who discharged him with follow-up with the GP. Mr C said that the assessment of risk and follow-up arrangements were not reasonable given his symptoms and circumstances at the time. Mr C also said that he had subsequently been diagnosed with psychosis (when someone perceives or interprets reality in a very different way from people around them) and that it was unreasonable that the psychiatrist did not consider this. We took independent advice from one of our medical advisers. We found that the standard of psychiatric care and treatment provided in relation to the assessment and follow-up arrangements were reasonable. In particular, the symptoms that Mr C presented with at the time were not consistent with a diagnosis of psychosis, and while it was possible that his presentation was an early sign or symptom prior to the development of psychotic symptoms at a later date, there was no evidence that this could have been predicted or anticipated. We did not uphold Mr C's complaint. Related reading View Decision Report 201800170 as a PDF (24.05 KB) Updated: February 20, 2019

Ms C complained about the treatment she received at the Royal Infirmary of Edinburgh. Ms C had a contraceptive device fitted and a number of months later she developed a number of symptoms including body aches, severe period pain, headaches and joint pain. Ms C only has one fallopian tube (either of a pair of tubes along which eggs travel from the ovaries to the uterus) and understood that the device should not have been fitted in patients with only one fallopian tube. Ms C complained about this and that she was not given anaesthetic during the procedure. We took independent advice from a consultant gynaecologist (a doctor who specialises in the female reproductive system). We found that although the information about the device does caution against patients with only one fallopian tube, it does not give specific reasons why this is so. There was no clinical reason why the device could not be used in Ms C's circumstances. We also found that adequate consent was obtained along with an explanation of the possible side effects which could be encountered. There was also no requirement for an anaesthetic as it was not a surgical procedure. Therefore, we did not uphold Ms  C's complaint. Related reading View Decision Report 201804414 as a PDF (23.94 KB) Updated: January 23, 2019

Miss C complained about the care and treatment she received at the Western General Hospital. Miss C had a history of breast cancer and at a routine examination a member of staff noticed some discolouration of the skin around the breast. Miss C was told by staff that they felt she may have dermatitis (a skin condition) and an urgent referral was made to the dermatology department (the  branch of medicine concerned with the diagnosis and treatment of skin disorders). Miss C was subsequently told that she had angiosarcoma (cancer of the inner lining of blood vessels, commonly found in the skin, breast, liver, spleen and deep tissue). Miss C felt that it was unreasonable that staff had thought she had dermatitis and by referring her to dermatology there was a delay in the treatment of her returning breast cancer. We took independent advice from a medical adviser. We found that Miss C's original breast cancer had not returned and that she had developed a rare but recognised complication of breast cancer treatment, angiosarcoma. In its early stages, this can often look like dermatitis or bruising. We found that staff acted appropriately by arranging an urgent dermatology review with investigations which resulted in the correct diagnosis. There was no evidence of any undue delay in the diagnosis. Therefore, we did not uphold Miss C's complaint. Related reading View Decision Report 201802900 as a PDF (24.01 KB) Updated: January 23, 2019

Ms C complained about the way her son (Mr A)'s psychiatrist dealt with communication from Mr A's father (Mr B). Mr A is estranged from Mr B, and the psychiatrist had been in contact with Mr B regarding some communication from Mr A to Mr B's work. Ms C and Mr A subsequently met the psychiatrist whose' contact with Mr B was discussed. Ms C said that the psychiatrist failed to deal with the matter in a reasonable way. We took independent advice from a medical adviser. We found that the quality of record-keeping in relation to clinical decisions made and the rationale for these in relation to the communication was poor. We also found that the relevant guidelines in relation to consent was not followed. Therefore, we upheld Ms C's complaint.

Mrs C complained that the board failed to prevent her baby (Baby A) developing hypothermia (the condition of having an abnormally and typically dangerously low body temperature) in the hours after their birth at the Royal Infirmary of Edinburgh. We took independent advice from a midwife. We found that Mrs C and hospital staff had different recollections of what was said about the reason why Baby A developed hypothermia. The medical records noted the likely reasons, such as possible infection or due to medication given to Mrs C during labour, but did not reach a definitive conclusion. We noted that staff gave Baby A antibiotics in line with relevant clinical guidance to ensure they recovered. We did not find evidence that the board acted unreasonably. Therefore, we did not uphold this aspect of Mrs C's complaint. Mrs C also complained that the board's response to her complaint was unreasonable. Mrs C was particularly concerned that Baby A's hypothermia could have developed because the birthing centre was too cold. We found that the board failed to investigate this specific part of Mrs C's complaint, and did not respond to her about it, despite having noted it in their acknowledgement letter. Therefore, we upheld this aspect of Mrs C's complaint.

Ms C complained about the care and treatment her husband (Mr A) had received at St John's Hospital following a suicide attempt. Ms C complained that Mr A was inappropriately given diazepam (a medicine used to treat anxiety), as it can be addictive. We independent advice from a consultant psychiatrist. We found that it might have been appropriate to have given Mr A diazepam on a short term basis but the reason for prescribing it to him was not recorded. We found that when Mr A self-discharged from the hospital, there was a failure to carry out and/or document an appropriate suicide risk assessment. There was no evidence that medical staff considered detaining Mr A. There was also no evidence that they signposted him to any other sources of support or carried out any contingency planning in case his condition or level of risk to himself changed. In addition, we found that a junior medical staff member was not able to reach a senior colleague by phone for advice. Therefore, we upheld this aspect of Ms C's complaint. We also found that the board had not handled Ms C's complaint regarding the diazepam appropriately and we made a recommendation in relation to this. Ms C also complained that there was a failure to provide Mr A with appropriate follow-up care after he self-discharged from the hospital. Mr A had been offered a follow-up appointment in two months' time. When he was unable to attend that appointment due to his poor mental health, he was offered an appointment for six months later. We found that Mr A was not given follow-up care that was appropriate to his needs, and that, in the circumstances, Mr A should have been offered an appointment within a week of him leaving the hospital. When Mr A could not attend that appointment due to poor mental health, he should have been offered a review at home. We upheld this aspect of Ms C's complaint.

Mr C complained about the treatment which he received when he attended the Western General Hospital for reported left upper abdomen pain. He said he had advised staff that he was allergic to aspirin and penicillin but was prescribed diclofenac medication (pain relief) on discharge. When he returned home, Mr C took two further diclofenac tablets and experienced breathing difficulties. He attended his GP the following day who prescribed alternative pain relief. Given his allergies, he felt that the diclofenac should not have been prescribed. We took independent medical advice from a consultant. We found that although diclofenac would not normally be prescribed for a patient allergic to aspirin it was not absolutely contraindicated and should be used with caution. We also found that diclofenac was a non-steroidal anti-inflammatory medication (NSAID) and Mr  C had advised the staff that he was able to tolerate some NSAIDs. We noted that Mr C had been given diclofenac whilst in hospital and that it had a good effect on his reported abdomen pain and he was given advice to seek further medical attention should his condition deteriorate following discharge. On balance, we found that it was reasonable for the doctor to have prescribed the diclofenac. We did not uphold Mr C's complaint. Related reading View Decision Report 201803249 as a PDF (23.96 KB) Updated: December 19, 2018