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Decision Report 201402832

  • Case ref:
    201402832
  • Date:
    October 2015
  • Body:
    Lanarkshire NHS Board
  • Sector:
    Health
  • Outcome:
    Some upheld, recommendations
  • Subject:
    clinical treatment / diagnosis

Summary

Mrs C complained about the treatment her father (Mr A) received from the board. In 2013 Mr A began to experience difficulties with his mobility and memory. Mr A was referred to the board's Falls, Stroke and Memory clinic at Coathill Hospital where he was seen by a consultant. A CT scan (computerised tomography scan) was arranged, which showed some shrinkage of the brain. The consultant referred Mr A for an MRI scan (magnetic resonance imaging scan - a more detailed scan than the CT scan). However, the radiologists questioned whether the scan was required, as they did not feel that an MRI would provide any additional useful information. They suggested a discussion with the referring consultant, however, Mrs C said that this did not take place.

Mr A was disappointed that the MRI scan did not go ahead and arranged for the scan privately. This resulted in a diagnosis of vascular Parkinsonism (a form of Parkinson's disease, a progressive neurological condition in which part of the brain becomes more damaged over many years). Mrs C complained that the radiologists inappropriately rejected a test that had been identified as necessary by Mr A’s consultant.

We took independent medical advice from one of our advisers. We accepted the advice that the consultant's decision to request an MRI scan was reasonable but that it is a radiologist’s duty to ensure that patients are not subjected to unnecessary imaging. When a radiologist believes imaging might be unnecessary, they should get clarification on the need for it. We were satisfied that a discussion did take place between the referring consultant and radiology, and that it was agreed that the MRI would not necessarily add anything to the diagnosis that had already been made. Whilst we found that Mr A’s treatment may have differed slightly had the MRI been carried out, we did not consider there to be a significant impact on his treatment.

We were critical of the board’s handling of Mrs C’s formal complaint and made a recommendation to address this.

Recommendations

We recommended that the board:

  • apologise to Mrs C for the failings in complaints handling which have been identified in this report.

Updated: March 13, 2018