Decision Report 202207983

Summary

C’s spouse (A) presented to A&E with neck pain. A was discharged home as it was noted that they were on a waiting list for an MRI scan, following an urgent referral by their GP to orthopaedics (area involving the musculoskeletal system). A was admitted to hospital four days later and advised that they were terminally ill with bladder cancer which had spread to the spine. A later died. C complained to the board that A&E did not consult orthopaedics or arrange further testing when A presented with continuing pain despite prescribed medication. The board’s response indicated that A was appropriately assessed by the A&E doctors and as A was waiting on an MRI, the discharge letter to the GP advised to follow up with the hospital where the MRI was being organised. The board said that the GP was best placed to expedite further care with the relevant team.

We took independent advice from a consultant in emergency medicine. We found that A&E carried out an appropriate assessment, including consideration of any red flags which warranted further investigation or onward referral. We found that as A had already been referred to the spinal team and had an MRI ordered it was reasonable not to investigate A further. We found that the board acted in accordance with NICE guidance in how they managed A’s care and treatment, which was reasonable. Therefore, we did not uphold the complaint.