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Case ref:201801911
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Date:October 2020
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Body:Greater Glasgow and Clyde NHS Board - Acute Services Division
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Sector:Health
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Outcome:Upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
C complained that the care and treatment they received from the board when they were admitted to Inverclyde Royal Hospital with severe abdominal pain was not reasonable. C raised issues regarding lack of a laparoscopy (a type of surgical procedure that allows a surgeon to access the inside of the abdomen and pelvis without having to make large incisions in the skin being performed), and delays in receiving a CT scan and antibiotic therapy. C had concerns that these issues contributed to the major surgery they ultimately underwent for suspected appendicitis (a painful swelling of the appendix).
We took independent advice from a general surgeon. We found that while a laparoscopy would have been helpful in diagnosing C's condition, it was not unreasonable that the board did not perform one in C's case. However, we found that a CT scan should have been performed earlier in C's admission, particularly when the decision was made not to perform a laparoscopy. We further found that it was unreasonable not to provide antibiotic therapy earlier in C's admission, given their presentation with features of infection. We found it was likely that, had the board performed a CT scan earlier, C would have undergone surgery earlier or received antibiotic therapy sooner, and this would have altered the clinical course with earlier and more minor surgery. As a result, we upheld this complaint.
Recommendations
What we asked the organisation to do in this case:
- Apologise to C for the failings identified in their care and treatment. 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:
- Patients should be managed so that they receive treatment and scanning based on their clinical presentation at the appropriate time.
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.