Overview
The complainant (Mr C) raised concerns regarding the care and treatment received by his late mother (Mrs A) at the Royal Infirmary of Edinburgh (the Hospital). Mrs A underwent surgery on 27 June 2007 for the removal of a pelvic cyst and a hysterectomy and Mr C was unhappy with the level of information provided prior to the surgery; the appropriateness of the decision to operate; the handling of the surgical complications and the timing of Mrs A's discharge. The specific points of complaint are listed below.
Specific complaints and conclusions
The complaints which have been investigated are that:
- (a) the consent process was not properly carried out and there was insufficient communication with regard to operative risks (partially upheld to the extent that the doctor obtaining consent did not have the appropriate level of seniority and experience);
- (b) the surgical decision-making process was inappropriate (upheld);
- (c) the surgical complications were not dealt with appropriately (upheld); and
- (d) Mrs A was discharged prematurely from the Hospital (not upheld).
Redress and recommendations
The Ombudsman recommends that the Board:
- (i) review their procedures to ensure that the process of obtaining patient consent is carried out by a clinician with an appropriate level of seniority and experience, ideally the doctor who will be carrying out the surgery;
- (ii) review their procedures to ensure that there is consultant involvement in decisions to proceed to surgery and in decisions regarding the type of surgery to be carried out;
- (iii) reflect on the delay in identifying Mrs A's intra-abdominal bleed and implement an action to prevent similar future failures;
- (iv) ensure that a proper multi-disciplinary approach to patient care is in place and seen to be effective; and
- (v) apologise to Mr C for the failings identified in this report.