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Case ref:201508333
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Date:May 2017
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Body:Greater Glasgow and Clyde NHS Board
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Sector:Health
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Outcome:Some upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Mr C complained that the staff at Glasgow Royal Infirmary failed to appropriately assess and treat his mother (Mrs A) when she was referred there by her GP. His concerns included that the consultant in acute medicine who treated Mrs A made a diagnosis of temporal arteritis (where the temporal arteries, which supply blood to the head and brain, become inflamed or damaged), despite there being no supporting evidence from investigations or tests. Mrs A was discharged home that day. Mr C also complained that the staff at the hospital failed to appropriately monitor and manage Mrs A's blood pressure readings when she was admitted the following day.
We obtained independent medical advice from a consultant physician in acute and internal medicine. The adviser explained that Mrs A was referred to the hospital by her GP as they felt she might have temporal arteritis and it would, therefore, have been reasonable for the consultant to have considered this condition as part of the list of possible diagnoses. The adviser explained that after examination and consideration of Mrs A's history and blood test results, the consultant, correctly, did not consider Mrs A to be suffering from temporal arteritis. However, the adviser said that Mrs A should have been admitted to the hospital and treated for her high blood pressure and failure to do so sat outside the scope of standard practice. Mrs A was subsequently admitted to the hospital the following day as a medical emergency. We upheld this part of Mr C's complaint.
The adviser said the board did not unreasonably fail to take into consideration the effect of the reintroduction of Mrs A's existing high blood pressure medications when assessing her fall in blood pressure, and that it would have been reasonable to start Mrs A on her blood pressure medication in the circumstances. Therefore, we did not uphold this part of Mr C's complaint.
Recommendations
We recommended that the board:
- provide Mr C and Mrs A with a written apology for failing to admit Mrs A to hospital for treatment of her high blood pressure; and
- feed back the failings identified to the doctor involved for reflection for future practice.