An investigation into the delayed diagnosis of a patient’s brain abscess has revealed a lack of communication in patient care, with doctors failing to pick up on crucial ‘red flag’ symptoms.
The patient, known as ‘Miss C’, visited her GP complaining of severe headaches and problems with her vision which were not relieved by painkillers. She was referred to the outpatient clinic at St John’s Hospital in Livingston, where on two occasions she was sent home with Ibuprofen and Co-codamol.
A subsequent scan revealed that she had a brain abscess. Miss C had to undergo emergency surgery at the Western General Hospital, followed by a further operation to drain the abscess.
Miss C raised concerns about the care and treatment she had received, particularly the delay in diagnosing her condition which may have led to a more serious outcome. She also had concerns about how the Lothian NHS board handled her complaint which was later referred to the Scottish Public Services Ombudsman (SPSO).
The Ombudsman investigates complaints where “a member of the public claims to have suffered injustice or hardship as a result of maladministration or service failure.” This is a service of ‘last resort’ as they look at complaints which have been through the formal complaints procedure of the organisation in question.
Investigations by the Ombudsman found that there were sufficient ‘red flag’ symptoms for Miss C’s condition to prompt doctors to investigate further. It was noted that errors had been made regarding Miss C’s medication and also that there had been poor communication with the patient and her family.
The Ombudsman was also critical that whilst the board apologised to Miss C, they did not explain how these errors had occurred. The Ombudsman stated, “Although it is not possible to know if an earlier operation would have improved the outcome for Miss C, I found that the board failed to give her the care and treatment she could have reasonably expected.”
As a result of this, the Ombudsman recommended that the Lothian NHS board apologise to Miss C. The board must report back following reviews of drug procedures and actions taken regarding communication. NHS Lothian has promised to adopt the Ombudsman’s recommendations and ensure lessons are learned from the case.
This is undoubtedly an example of patient care failing to meet acceptable standards as Miss C suffered unnecessary and prolonged pain and distress. However, it would only be possible to make a clinical negligence claim if the outcome had been worse for Miss C. In cases such as this, if better treatment would have made no difference to the outcome, there is no civil claim.
Miss C’s case demonstrates that the SPSO and the Parliamentary Health Service Ombudsman in England and Wales provide important public services. The Ombudsman provides recommendations in ‘last resort’ cases of substandard NHS care and attempts to ensure that patients do not suffer similar problems in the future.
Ellen Driscoll is a Paralegal in the Clinical Negligence department of Slater and Gordon Lawyers in Manchester.
Slater and Gordon Lawyers help people who have suffered from delayed or wrong diagnosis of diseases due to Medical Negligence.
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