SPSO Individual Decisions

Mr C made a number of complaints about the care and treatment he received in Ninewells Hospital. He had been admitted following a hernia operation at another hospital. At Ninewells, he was found to have a haematoma (bruise) and there was also some evidence of infection. We found that Mr C had been monitored appropriately following his admission to the hospital. The SEWS (the Scottish Early Warning Score) charts had been completed regularly and appropriately throughout his admission. There was no evidence to suggest that the monitoring, assessment and management of his pain was not reasonable. Although Mr C complained that he was not provided with his regular prescribed medication until the day after he was admitted, the drug administration record showed that he had self-administered some of his medication on the day of his admission. We found that staff clearly failed to provide him with other medication that he needed, but had not taken to the hospital. We upheld Mr C's complaint about this. However, we did not make any recommendations, as the board had already apologised to Mr C and were taking action to reduce the likelihood of similar problems recurring. Mr C also complained that the board did not provide him with oral antibiotics for 26 hours after he was taken off an intravenous antibiotic drip, despite his repeated requests and complaints. We upheld this complaint, as the records were not clear on the matter. It was not possible for us to say categorically whether there was a delay in providing him with oral antibiotics or whether the original intention was that the antibiotics should be stopped. We did not consider that Mr C was asked inappropriate questions in A&E or that the questions were unnecessarily duplicated when he was transferred to a ward. Mr C also complained that the records of his stay in the hospital had been fabricated. We found no evidence of this. In addition, we found that the board's handling of his complaint was satisfactory. Recommendat

Mr C complained that his practice failed to provide a reasonable standard of medical care on a number of occasions. He went to his practice complaining of pain and was prescribed a drug that he said led to his collapse later in the evening. Later, he went to his practice complaining about severe indigestion and nausea which he believed was a reaction to the medication he was prescribed and was eventually prescribed a different medication. Following an operation, Mr C sought treatment from the practice when he had discomfort and his wound began to leak. He did not receive treatment and went to hospital where he said he was diagnosed with internal bleeding. We found that on the whole the care and treatment Mr C received from the practice was reasonable. Mr C was prescribed a drug that should have been used with caution, but that there were no contraindications to its use and it was discontinued the following day. We found no evidence that the practice failed to provide a reasonable standard of care to Mr C on the other occasions. Related reading View Decision Report 201101060 as a PDF (19 KB) Updated: March 13, 2018

Mrs C said that for eleven years she had been prescribed MST (morphine sulphate based medication) but had received a letter from her medical practice saying that the drug would no longer be prescribed. Mrs C complained that she had asked for the decision to be reconsidered but was told it was final. Mrs C said that because of the decision to stop her prescription she suffered very badly from withdrawal symptoms. As part of our investigation, we discovered that the medical practice had received anonymous information alleging that Mrs C was selling her MST tablets. Because of this the practice requested a toxicology report on a urine sample. This did not show the presence of opiates and so the medical practice considered that it was reasonable to stop prescribing them. As it appeared that Mrs C was not taking the MST prescribed to her, the practice also considered it unlikely that she would have suffered withdrawal symptoms. We did not uphold the complaint but we made a recommendation to the practice. Recommendation We recommended that GPs at the practice: • in future similar cases should seek patient consent before a toxicology screen is requested. Related reading View Decision Report 201100446 as a PDF (18.62 KB) Updated: March 13, 2018

Mr C had requested a home visit early in 2010 which was refused. In December 2010 he contacted the practice by email to ask why the visit had been refused and to ask for a copy of the practice policy on home visits. The practice manager responded five days later by email explaining the policy on home visits. The final paragraph of the emailed letter stated that Mr C's previous email had 'sullied' the patient / doctor relationship and Mr C was to be removed from the list. Mr C complained that the decision to remove him from the GP list without prior warning was unreasonable. We found that it was not appropriate for the practice to have taken the action they did without first giving Mr C a warning and we, therefore, upheld his complaint.