Investigation Report 201002636

  • Report no:
    201002636
  • Date:
    August 2011
  • Body:
    Greater Glasgow and Clyde NHS Board - Acute Services Division
  • Sector:
    Health

Overview
The complainant (Mrs C) raised concerns on behalf of her mother (Mrs A) regarding the treatment that she received from Greater Glasgow and Clyde NHS Board (the Board). Mrs A attended Victoria Hospital (the Hospital) after breaking her ankle. She was treated for this but subsequently experienced severe pain and blistering around the ankle. Mrs A was later found to have a second fracture, which had previously been undetected. Mrs C complained about the Board's failure to diagnose the second fracture and about the initial treatment that Mrs A received, which she believed caused her blistering.

Specific complaints and conclusions
The complaints which have been investigated are that:

  • (a) the Board failed to diagnose Mrs A's os calcis fracture in good time (upheld);
  • (b) the Board's treatment of Mrs A's broken ankle was inappropriate (upheld); and
  • (c) the Board's complaint handling was poor (upheld).

 

Redress and recommendations
The Ombudsman recommends that the Board:

  • (i) present Mrs A's case and this report's findings to Orthopaedic, A&E and complaint handling staff at a suitable staff forum, such as a mortality and morbidity meeting;
  • (ii) review their procedures for assessing patients' suitability for discharge to ensure that social and medical considerations are given the appropriate consideration; and
  • (iii) consider providing further training to staff on patient discharge eligibility assessment.

 

The Board have accepted the recommendations and will act upon them accordingly.

Updated: December 11, 2018