Overview
The complainant (Mrs C) raised a number of concerns about the treatment she received at Borders General Hospital (the Hospital) following cataract surgery. Mrs C had concerns that she had received insufficient information about the proposed surgery and choice of anaesthetic; that an inappropriate method of anaesthetic was used; and when problems occurred following the surgery there was a delay in her being referred for specialist assessment.
Specific complaints and conclusions
The complaints from Mrs C which I have investigated are that:
- (a) the information and advice provided to Mrs C before surgery was insufficient to allow her to make a fully informed decision or to give valid consent for surgery (not upheld);
- (b) the pre-operative assessment was inadequate in that Mrs C was not assessed by her surgeon prior to surgery and the assessment did not take full cognisance of the particular risks involved (not upheld);
- (c) the choice of sharp needle anaesthesia was inappropriate and unreasonable (upheld);
- (d) the post-operative care and treatment was inadequate. In particular, that there was an unreasonable and unexplained delay in referring Mrs C for a specialist opinion (upheld); and
- (e) the complaints handling by Borders NHS Board (the Board) was inadequate (upheld).
Redress and recommendations
The Ombudsman recommends that the Board:
- (i) remind staff of the risks of carrying out sharp needle anaesthesia in patients with high myopia;
- (ii) apologise to Mrs C for perforating her eye during surgery;
- (iii) remind staff of the need to refer patients for specialist opinion as soon as the clinical situation has been identified;
- (iv) apologise to Mrs C for the delay in making a specialist referral; and
- (v) remind staff of the need to conduct a Critical Incident Review where an adverse incident has occurred in order to establish whether practices require to be amended.
The Board have accepted the recommendations and will act on them accordingly.