An NHS board has been told to apologise after staff missed an early opportunity to diagnose a patient with a broken back.
The Scottish Public Services Ombudsman NHS said that the care provided to the patient was “unreasonable” and “not to an acceptable standard” in this instance.
The apology comes after a complaint was brought to the attention of the SPSO. It follows a case that centred on an NHS patient who’d initially suffered a fall and was treated with painkillers for neck pain.
The patient was discharged from hospital the following day, when the patient suffered another fall. It was only after the second admission that the patient was diagnosed with a fracture of a bone in their neck.
A complaint was raised by a member of the patient’s family, known only as ‘C’. The patient at the centre of the case is only known as ‘A.’
An extract from the SPSO report said:
“C complained about the care and treatment provided to their parent (A) over two admissions to hospital. A attended the emergency department following a fall at home and was treated with painkillers for a pain in their neck. They were admitted to the ward for further monitoring of their fast and irregular heartbeat.
“A was reviewed the next morning and discharged that day. However, A returned to hospital later that day after another fall. A was reviewed and admitted to the ward – where they were later diagnosed with a fracture of a bone in their neck.”
The family member then complained that the board ‘failed to diagnose’ the fracture on the first admission to hospital and about the decision to discharge A.
The SPSO said:
“In response to the complaint, the board did not identify any failings with respect to assessment of A, but acknowledged that the communication of their diagnosis and discharge could have been better.
“With respect to the second admission, the board explained that symptoms of neck fracture are not straight forward and the examinations carried out within the emergency department were appropriate. C was dissatisfied with the response and brought their complaint to our office.”
The report continues:
“We took independent advice from an emergency medicine consultant and a consultant geriatrician (specialist in medicine of the elderly).
“In relation to A’s first admission, we found that the initial assessment of A’s condition in the emergency department was reasonable, although there was a missed opportunity for further assessment before A went to the ward.
“However, the examination and assessment of A’s neck pain on the ward was unreasonable, as was the assessment of A’s suitability for discharge, given the failure to properly assess A’s neck injury, mobility, and cognitive function.
“We found that the board failed to provide A with appropriate care and treatment during their first admission and upheld this part of C’s complaint.”
In relation to the patient’s second admission, the SPSO found that the neurological examination “did not include” a cervical spine assessment.
The SPSO said:
“The board acknowledged in their correspondence with our office that the care provided at this time was not to an acceptable standard. Therefore, we determined that the care provided in the emergency department was unreasonable.
“We found that the care and assessment provided during A’s admission to the ward was reasonable, and there was no delay in arranging further investigations.
“Given our findings in respect to the care provided in the emergency department, we upheld C’s complaint regarding A’s second admission to hospital.”
The SPSO has now requested NHS Ayrshire & Arran apologise to the patient and their family member for the “failures identified.”
The SPSO report highlighted:
“Clinical staff should be familiar with relevant NICE (National Institute for Health and Care Excellence) guidelines on the management of suspected cervical fractures.
Relevant departments concerned should review their practices regarding the assessment of pain and investigation of potential head/neck injury.
“Patients should only be discharged following appropriate review and assessment of all clinical factors relevant to the decision to discharge a patient from hospital.
“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.”
In a statement from NHS Ayrshire & Arran Executive Nurse Director, Jennifer Wilson, she said:
“We apologise that we did not meet the high standards of care we aim to provide at NHS Ayrshire & Arran.
“The Board fully accepts the recommendations in the Scottish Public Services Ombudsman (SPSO) report.
“We have issued a formal apology to the family of patient A, and are working through the recommendations highlighted in the Scottish Public Services Ombudsman (SPSO) report.”
Clinical Negligence – When to make a claim
Mistakes made by medical professionals can cause prolonged suffering and serious consequences for the patient involved. If you have suffered as a result of medical negligence, you may be entitled to claim compensation.
Whether you have suffered due to incorrect prescriptions, a delay in diagnosis which resulted in an injury, misdiagnosis of an illness or disease, surgical errors during an operation, or neglect and injuries during childbirth, for either mother or baby, you may be entitled to claim.
NHS Scotland doctors, nurses and other staff must adhere to high standards of care at all times, however negligence does occur.
Criteria to make a claim
To make a medical negligence claim in Scotland, three elements must be proved:
- There is a duty of care owed by the clinician/medical professional to the patient
- The duty has been breached
- The breach in the duty has caused harm to the patient (and the harm was reasonably foreseeable). This is referred to as ‘causation’.
Time limits to make a claim
In Scotland, the time limit for making a medical negligence claim is three years from the date of the incident or from the date that you became aware of the negligence. This is known as the limitation period.
If you’re under 16 years of age at the time of the incident, the three-year limitation period begins on your 16th birthday. If you’re claiming on behalf of someone who has died as a result of medical negligence, the three-year limitation period begins from the date of death.
It’s essential to note that there are some exceptions to the three-year time limit. For example, if you’re claiming on behalf of someone who is mentally incapacitated, there is no time limit for making a claim. Similarly, if you’re claiming for a child who has suffered a birth injury, the limitation period doesn’t begin until the child turns 16.
Why Use Oakwood Scotland Solicitors?
Oakwood Solicitors Ltd is an expert in medical negligence cases and has over twenty years of experience in running and pursuing these cases.
We will ensure that we update you at every stage of the case and you will have a dedicated handler from the very beginning. We know it can be very stressful and our team can assist you by breaking down the legal jargon during the process and listening to you.
When you instruct us, you can expect a friendly, down to earth approach together with extensive knowledge of the field which will be used to fight tenaciously with the insurers to achieve the maximum level of compensation possible for you.
Further reading
Clinical Negligence – Oakwood Scotland Solicitors
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