Decision Report 201406418

Summary

Mrs C complained that doctors at Monklands Hospital did not examine her mother (Mrs A)'s ear for infection, or do a CT scan (computerised tomography: a scan which uses x-rays and a computer to create detailed images of the inside of the body), when she went to the hospital's emergency receiving unit. Mrs C felt that hospital staff did not take all steps to ensure that Mrs A received the best care.

We looked at Mrs A's medical records, and we took independent advice from one of our medical advisers. We also took into account relevant clinical guidance in Scotland about the diagnosis and management of headache in adults. The guidance referred to 'red flag' features, some of which could have applied in Mrs A's case given what was recorded in her medical and nursing records. We concluded that a CT scan should have been carried out, or at least the relevant hospital staff should have specifically recorded the decision not to perform a CT scan, in line with the guidelines. We also found that hospital staff should have examined Mrs A's ear for infection. We upheld Mrs C's complaints.

Recommendations

We recommended that the board:

• apologise to Mrs C and Mrs A's family for the failings identified in our investigation;
• remind relevant staff, in particular locum consultants who usually work elsewhere in the UK, of the specific national guidelines which are used in Scotland; and
• make reasonable efforts to share the result of our investigation with the staff involved.