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Case ref:202105870
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Date:August 2022
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Body:Highland NHS Board
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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 board failed to fully consider an allergic reaction to a wasp sting as the cause for their blackout which occurred when driving a HGV (heavy goods vehicle). When C was taken to hospital following the incident, a tryptase test was taken (a test to diagnose anaphylaxis, an acute allergic reaction). An ECG (a test to check the heart's rhythm) showed that C had an irregular and fast heartbeat and an EEG (a recording of brain activity) showed abnormal results with potential epileptic activity. Due to these findings, C was instructed not to drive and the DVLA were informed.
We reviewed the medical records and took independent advice from an acute medicine adviser. We found that while it was reasonable for the board to arrange for further investigations given that there were a number of potential causes for C's blackout, it would have been reasonable to further investigate an anaphylactic cause for the collapse once the tryptase result was available. Instead, C decided to seek private specialist opinion and the board only referred C to an allergy specialist after a significant amount of time and correspondence from C. We therefore upheld the complaint.
Recommendations
What we asked the organisation to do in this case:
- Apologise to C for the failure to fully consider an allergic reaction as the cause for C's blackout. 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:
- Potential causes of blackouts/collapses should be fully investigated.
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.