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Case ref:201101357
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Date:March 2012
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Body:Highland NHS Board
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Sector:Health
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Outcome:Some upheld, no recommendations
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Subject:clinical treatment; diagnosis
Summary
Mrs C's infant son (Master A) had a history of throat problems, reflux and allergies. Mrs C was concerned that he was having problems while sleeping, and she was not happy with the investigations and treatment provided by the board. The specific complaints we investigated were that there was an avoidable delay in fully investigating and diagnosing Master A's condition, and there was an error in a letter from the board regarding the date when Master A's 'failure to thrive' was diagnosed. Mrs C was also unhappy that the board had not explained to her why a flexiscope examination (a specialist examination of the throat using a camera device) was not carried out on Master A more recently.
We found from looking at the evidence, and taking advice from two of our medical advisers, that there was no reason to have repeated a flexiscope in Master A's case. In terms of referrals, investigations and treatment within the board, there was no evidence of avoidable delay. There was a delay in Master A having a polysomnography (sleep study), as he remained on a waiting list in another health board area. However, the board had limited, if any, influence over how quickly a referral to another health board would be actioned as it was not within their direct control, and there was evidence that they had pursued the referral with the other health board. As the referral had not taken place, the board acted correctly in referring Master A to a third health board area, where he was seen. Therefore, we found no evidence of avoidable delay by the board, and did not uphold this complaint.
In their letter to Mrs C, the board stated a date when 'failure to thrive' was first identified. The clinical records showed that a suggestion of 'failure to thrive' was first noted about a year previously. On that basis, we found that the board's letter to Mrs C should have accurately reflected this and, therefore, we upheld this complaint. Our decision notice drew this error to the board's attention and, therefore, we did not make any recommendations.