Child given morphine overdose by medics

A child was given an overdose of morphine during a bungled treatment at an NHS Ayrshire and Arran medical facility.

And medical staff ‘failed’ to document that they carried out “close observation” on the child in the wake of the incident.

Details of the incident have been revealed in a complaint made to the Scottish Public Services Ombudsman (SPSO) by the child’s parent/guardian.

The parent/guardian’s identity has been withheld by the SPSO due to confidentiality reasons.

The complainant is, however, referred to as “C” while the child was referred to as “A.”

In the report the SPSO said: “C complained to us that the board had unreasonably given their child (A) an overdose of morphine.

“We took independent advice from a consultant paediatrician (a doctor who specialises in child medicine).

“We found that A had received an overdose of morphine as a result of a doctor failing to discard excess morphine from a syringe and giving them the full syringe. We upheld this aspect of the complaint.”

C also complained that the board then “failed to carry out observations” on A appropriately after the error was identified.

The SPSO said: “We found that staff had recognised the need for close observation, but the observations were not clearly documented in A’s clinical records and we were unable to say definitively whether or not the observations were carried out appropriately. Therefore, we upheld this aspect of the complaint.”

A third aspect of the complaint centred on a ‘failure’ to provide a reasonable response to the initial complaint.

And once again, NHS Ayrshire and Arran were found culpable.

The Ombudsman said: “We found that there had been an unreasonable delay in responding to the complaint. Also, there was no evidence that the board had kept C updated during this time. We upheld this aspect of the complaint.”

The SPSO added: “We noted that the board had already apologised for these failings but we made further recommendations for learning and improvement.”

Joanne Edwards, Director of Acute Services, said: “In addition to our formal apology to the family of child A, I can advise that we have fully accepted all the recommendations in the Scottish Public Services Ombudsman (SPSO) report. We have addressed the issues highlighted and made the appropriate changes.”