Decision Report 201403540

Summary

Mrs C complained about the care and treatment her late mother (Mrs A) received at Forth Valley Royal Hospital. Mrs A was admitted with kidney failure and, further to treatment, was discharged eight days later. However, she became ill again the following day and required re-admission. She responded well to treatment, this time for heart failure, but subsequently suffered a sudden heart attack and died. Mrs C raised concerns that the board did not take reasonable account of Mrs A's pre-existing heart problems when treating her kidney failure during her first admission. She felt that this led to them overloading her with fluids, thus contributing to her subsequent heart failure and eventual death. She also questioned the appropriateness of the discharge following Mrs A's first admission, raising concerns that her heart failure should have been detected prior to this and noting that Mrs A had been vomiting on the day of discharge.

We took independent advice from one of our medical advisers, with experience in the acute hospital care of elderly patients with multiple illnesses. He explained that the treatment of kidney failure involves fluids being provided, whereas the treatment of heart failure requires fluid restriction. He advised that a careful balancing act was required where a patient has both kidney and heart problems. He considered that the doctors caring for Mrs A were mindful of this and said the treatment provided to her during both admissions was reasonable. He also considered the interim discharge to have been clinically appropriate at the time. He said Mrs A's sudden heart attack could not have been predicted and was not connected to her treatment. We accepted this advice and did not uphold the complaints.