Decision Report 201401159

Summary

Mr C complained about the nursing care and treatment provided to his late wife (Mrs C) and also complained that when her condition deteriorated she was not transferred to the Intensive Treatment Unit (ITU). Mrs C had a previous medical history which included Type II diabetes, heart disease, and kidney problems and she had been progressively unwell several months before she was admitted to Forth Valley Royal Hospital. At that time she was complaining of a six-week history of breathlessness, an unproductive cough, reduced exercise tolerance, and increasing leg oedema (swelling due to fluid retention). Mrs C was treated with drugs to fight infection and to reduce fluid retention but her condition failed to respond and she died around four weeks after being admitted.

We took independent medical advice from one of the Ombudsman's nursing advisers and a consultant who specialises in care of the elderly. We found that although the nursing treatment was reasonable, appropriate and timely, there were some failings in the nursing care provided including failure to appropriately supervise Mrs C when she was self-administering her insulin (a drug used to treat diabetes); to deal appropriately with urine samples; and to communicate the seriousness of Mrs C's condition to Mr C and members of the family. These failings had already been acknowledged and apologised for by the board in their responses to Mr C's complaint to them, and an action plan had been implemented to address the issues, including ongoing staff education. Therefore, although on balance we upheld this aspect of Mr C's complaint, we did not make any recommendations as we considered that appropriate action had already been taken by the board.

On the medical treatment provided to Mrs C, our consultant adviser said that Mrs C received appropriate assessments, investigations, specialist reviews and modifications of treatment where required. On the specific issue of transfer to the ITU, we found that when Mrs C's condition deteriorated, she had been appropriately reviewed and her treatment was modified accordingly. She was then reviewed shortly after by an ITU consultant. By the time of the ITU review, Mrs C's condition had improved and then remained clinically stable, although she was still very unwell, for the next few days. The decision was taken that admission to the ITU would be unlikely to achieve any further improvement in Mrs C's condition and we considered that this was a reasonable decision, so we did not uphold this aspect of Mr C's complaint.