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Case ref:201508222
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Date:November 2016
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Body:Grampian NHS Board
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
Mr C complained about the care and treatment provided to him at Grampian Royal Infirmary following his diagnosis of prostate cancer. Mr C said that he had not been provided with all the information necessary for him to give informed consent for the prostate surgery he had undergone. Mr C said that the board had failed to provide him with a test result which showed that the indicator used to measure the cancer's activity had declined.
The board said that Mr C had been managed and advised appropriately. They accepted that he had not been provided with the test result, but said this was not required for him to have given his informed consent. Additionally the board noted that Mr C had had a number of detailed discussions with his clinicians about his treatment options.
We took independent medical advice on the treatment provided to Mr C. The adviser said that Mr C's management and treatment were in line with the appropriate clinical guidelines. It noted that Mr C had delayed his treatment as he had wished to travel abroad during it. During this trip, a test of his cancer indicators had shown a marked rise. The advice noted that the test Mr C was not informed about showed a lower level of this indicator. The medical decision to operate on Mr C was based on the assessment of a scan of his prostate, and a subsequent examination of the cancer showed it to be more serious than previously thought. The advice said this supported the decisions made by medical staff.
We found that the test level was not the determining factor in deciding whether Mr C should have undergone surgery. We found that for informed consent, Mr C needed to be provided with sufficient information to understand the reason for his surgery, the risks and benefits of the proposed treatment and the alternatives available to him. The evidence showed that this had been done and that the treatment Mr C was provided with was the appropriate one. We did not uphold Mr C's complaint.