Decision Report 201905433

Summary

C fell and injured their head, requiring emergency surgery and the removal and replacement of part of their skull. Tayside NHS board carried out the surgeries and provided rehabilitative care. C complained that the board failed to properly insert the ceramic bone replacing the portion of skull taken out, causing disfigurement. C was also not satisfied with the explanations given by the board in relation to the care provided.

We took independent advice from a consultant neurosurgeon (a surgeon specialising in surgery of the brain and nervous system). We found that the board provided reasonable treatment to C. C’s injuries required two emergency operations, both of which were reasonably carried out. The board provided a custom-made plate to replace the portion of the skull lost due to the head injury. The surgeries and follow-up care provided to C were of an extremely high standard. While there was a complication with one of the surgeries, this was a known complication for cranial surgery which the board accepted and apologised for. After the operations were completed, the board provided rehabilitation to C through multiple rehabilitation schemes. This was reasonable. As such, we did not uphold this aspect of C's complaint.

We also considered C’s complaints that the board had failed to provide a reasonable explanation about the treatment they received. We found the board provided reasonable explanations to C about the treatment they provided. Clinicians spoke with C on multiple occasions to discuss the outcomes of the surgeries. The board took account of C’s cognitive difficulties when communicating with them and exceeded the level of standard care required in terms of communication. The board’s response to C’s complaint explained the outcome of C’s surgeries including the impact on C’s facial appearance. This was reasonable. As such we did not uphold this aspect of the complaint.