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Case ref:201204877
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Date:February 2014
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Body:Orkney NHS Board
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Sector:Health
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Outcome:Upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Mr C hurt his head when his vehicle overturned. He said that when he arrived at hospital he walked in without a wheelchair or a neck brace. He was examined by a doctor, who instructed a nurse to dress Mr C's head wound and advised him to take painkillers. After this, Mr C attended two GP appointments, but went to hospital again about two weeks later feeling faint and woozy. He said he was left unattended for an hour until seen by a doctor, who did not examine him and advised him to buy painkillers from a shop. A few days later, Mr C saw a consultant who told him that there was nothing wrong and to continue with the painkillers. Mr C complained to us that the board failed to provide a neck collar, and did not properly clean the wound and investigate his injury. Finally, he said that they did not take him seriously when he attended hospital several weeks later.
We took independent advice on this case from one of our medical advisers, who specialises in emergency medicine. The adviser said that there were failings in the care and treatment provided immediately after Mr C's accident. When he was taken to the emergency department, he was not immobilised as he should have been. Given the nature of his injury, it was possible that he might have had a neck fracture, which should have been ruled out through careful examination before he was mobilised. A more thorough investigation might also have highlighted the need for an x-ray. However, there was evidence in the medical records that his wound was treated appropriately. Furthermore, after Mr C's initial attendance at hospital, the adviser said that management of the injury and subsequent symptoms was reasonable. We accepted that advice, but upheld the complaint as we were concerned about the management of his injury immediately after the accident.
Recommendations
We recommended that the board:
- ensure that the failures identified are raised as part of the annual appraisal process of relevant staff; and
- apologise to Mr C for the failures identified during our investigation.