Family is to receive apology over mum’s care in hospital
HEALTH board bosses have been ordered to apologise to the family of a cancer patient who broke a bone in her back while a patient in hospital.
The woman, who is referred to as Mrs A, was in Glasgow Royal Infirmary for a review of her care when she fell.
She was given a scan and was discharged two days later but the scan results were only issued six days after the procedure was carried out.
It showed a fracture to a bone in the base of her spine but Mrs A’s family was told the scan was clear.
They cared for her at home but were worried about her continuing back pain and asked her GP to check the scan results with the hospital.
The patient’s daughter, who is referred to as Miss C, said the family was told their mum had suffered a fracture to a different bone in the base of the spine. Sadly, Mrs A died the following day.
Miss C was concerned the family had been looking after their mother without being aware of the fracture and complained to the Scottish Public Services Ombudsman.
It is the final stage of complaints about councils, the NHS, housing associations, colleges, universities, prisons, most water providers, the Scottish government and most Scottish authorities.
The Ombudsman investigated the complaint and has now issued a report saying the complaint has been upheld.
It says: “Miss C complained to us that the family had not been reasonably informed about the results of the scan.
“We took independent advice from a consultant in general med- icine and a radiologist.
“They noted the fracture was clearly visible on the scan but although the hospital’s computerised audit trail showed staff had reviewed the scan, this was not documented.
“There was no evidence the results had been communicated to Mrs A or her family.
“While we did not find evidence staff had given incorrect information to Mrs A or her GP, we were critical that staff did not identify the fracture and share this information. We therefore upheld this complaint.”
The Ombudsman has recommended the Health Board apologises to Miss C’s family for the failings found during the investigation, that findings about lack of documentation and communica- tion of the scan results are fed back to the medical staff involved and that any staff training needs in relation to interpreting scans is reviewed.
A health board spokesman said: “We accept communication about the X-ray findings was below the standard we would expect.
“In this instance, a member of staff assessed the X-ray and allowed the patient to be discharged without documenting this in the case notes or involving a more senior member of the team.
“We have reinforced the importance of appropriate documentation and communication to staff.
“We will be formally writing to the family offering our apologies for failing to ensure they were not reasonably informed about the results of the patient’s X-ray.”