Decision Report 201901150

Summary

C complained on behalf of their spouse (A). A had a history of metastatic cancer (cancer which has spread to another part of the body). A attended their GP with a sudden on-set headache and was advised to attend the Glasgow Royal Infirmary (GRI). A arrived at GRI as an emergency attendance and was admitted for investigation. Scans were carried out which revealed that A had an intracranial metastasis (a malignant growth that had spread to the brain from a tumour in another organ). C complained that there was an unreasonable delay in the scans being carried out. C also complained that A had unreasonably been advised that surgery was not an option.

We took independent advice from a consultant in acute medicine and from a consultant radiologist (a doctor who specialises in diagnosing and treating disease and injury through the use of medical imaging techniques). We found that there had been an unreasonable delay in the first scan being carried out given A's history, current medications and symptoms. All relevant information was not provided to the radiologist to determine the priority of the scan and, when the scan was not carried out as planned, the board failed to query this with the radiology department when it had not occurred as scheduled. We upheld this aspect of C's complaint.

In relation to the second complaint there was little information available to confirm exactly what was said between the board, C and A regarding the discussion that surgery was not an option for A. We found, based on the information available, that the board had reasonably informed A that curative surgery was not an option in relation to their intracranial metastasis. Therefore, we did not uphold this aspect of the complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C and A for failing to carry out A's scans in a reasonable timescale. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

What we said should change to put things right in future:

• All relevant information should be provided to the radiology department when requesting a CT scan.
• Patients presenting with a headache and taking anticoagulant medication should receive appropriate investigations to identify whether an urgent scan is needed.
• The board should carry out scans in the timeframe agreed.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.