Decision Report 201405247

Summary

Miss C complained to us about the care and treatment she had received when she attended the A&E department at Forth Valley Royal Hospital. Miss C had gone to A&E after injuring her ankle. She said that she also told staff that she had sickness and diarrhoea, and that she had a rash on her forehead.

Miss C returned to the A&E department two days later with shortness of breath, swelling in the right leg, bruising and a rash. She was assessed as requiring immediate attention and was then diagnosed as having myositis (inflammation of the muscles) caused by group A streptococcus (a bacterial infection). She required treatment in the intensive care unit and several emergency operations, including an above-the-knee amputation of her right leg. She also had surgery on her other limbs.

Miss C said that she had not received reasonable care and treatment when she had first attended the A&E department, and had been seen by an emergency nurse practitioner. We took independent advice from one of our nursing advisers, who is an emergency nurse practitioner. The medical records that were completed when Miss C had initially attended the A&E department only referred to an injury to her left ankle. No other symptoms were documented. We found that it had been appropriate for the emergency nurse practitioner to diagnose and treat this minor injury, and that the care and treatment the nurse practitioner had provided had been reasonable and appropriate. As there was no evidence that Miss C had reported sickness, diarrhoea or a rash when she attended the hospital on the first occasion, we did not uphold the complaint.