Decision Report 201903628

Summary

C underwent planned laparoscopic cholecystectomy surgery (surgery to remove the gall bladder through several small cuts made in the abdomen) at University Hospital Crosshouse and was dissatisfied with the care and treatment they received. C stated that prior to discharge they felt unwell but asserted that their concerns and symptoms were dismissed, their request for review by a doctor was dismissed and they were forced out of recovery for discharge home. C experienced worsening symptoms thereafter and was readmitted to hospital ten days later. C underwent further care and treatment in the hospital setting.

The board said that there were no complications during C's planned surgery or thereafter. C met discharge criteria, so it was appropriate that they were discharged. The board acknowledged that C was readmitted and underwent further treatment but said that the only potential explanation was that a recognised complication arose.

We took independent advice from an appropriately qualified adviser. We found that the standard of C's planned surgery, performed by a registrar, was reasonable and supervised by the consultant. There was no evidence to suggest that the surgery was done without care nor that there were any problems. We noted that complications can occur despite a reasonable standard of surgery. During the immediate postoperative period, the management and provision for C's pain control appeared reasonable; C was regularly reviewed and given adequate pain control with satisfactory support from nursing staff. Despite this, C's symptoms should have prompted a review by a member of the clinical team. However, we noted that nurse-led discharge criteria give broad latitude to judgement on when to call the medical team and give inadequate guidance about when to seek support. On balance, we did not uphold this complaint. However, we provided feedback to the board with suggested improvements to their discharge criteria.