FCMS

2. Mrs A complains about the care and treatment she received in a hospital run by FCMS, in May 2021. She complains doctors in the Emergency Department’s (ED) Urgent Care Centre (UCC) missed her symptoms of appendicitis and diagnosed her with gastroenteritis and dehydration instead.

3. Due to the events Mrs A complains about, she needed major surgery performed by a specialist. She has experienced ongoing pain and complications, which have reduced both her quality of life and her working hours.

4. By bringing this complaint to us, Mrs A wants financial compensation for the cost of private pain management, missed holidays and working limitations caused by a long recovery time.

5. Mrs A had been suffering from abdominal pain that had gradually worsened. This caused her to attend the ED on 31 May 2021. Once triaged by the ED, Mrs A was referred to the UCC in the hospital. She was seen in the UCC by a GP who, after examination, sent Mrs A home with suspected gastroenteritis and dehydration.

6. Mrs A’s symptoms did not go away, and she went to see her own GP on 3 June 2021. Her GP was concerned she had appendicitis and called the hospital to have her admitted immediately. Mrs A then had an emergency appendectomy (an operation to remove the appendix) the following day and was told her condition was so severe that her appendix had fused itself to other organs in her body.

7. She complained to FCMS and it provided a final complaint response on 27 July 2021. She brought her complaint to us in May 2022.

13. Mrs A was suffering from severe abdominal pain and attended the ED on 31 May 2021 to seek medical help. She says a doctor pressed her stomach and asked her if she had been drinking alcohol before informing her they believed she had gastroenteritis coupled with dehydration. Someone close to Mrs A had recently developed appendicitis, and she felt her symptoms were very similar. She raised this with the doctor, who dismissed her concerns and reiterated she should go home and drink fluids.

14. Mrs A says after she was discharged home the same day, her symptoms did not improve and she remained in pain. On 3 June 2021, Mrs A saw her GP, who immediately suspected appendicitis and called the hospital to make sure she was seen immediately. She was admitted and had a five-hour emergency appendectomy. Mrs A says the surgeon informed her the infection had been so severe her appendix had fused to other organs, and a specialist had to be called in to complete the operation.

15. On 11 June 2021, Mrs A complained to the Trust, which advised her she had been seen at the UCC, which is run by FMCS. The Trust passed the complaint on to FCMS.

16. In its short complaint response on 27 July 2021, FCMS said appendicitis is difficult to diagnose. It says Mrs A was given the correct information at the time of treatment and received good ‘safety netting’. It did not explain what that entailed but concluded nothing had gone wrong.

17. We considered Mrs A’s clinical records, including from the Trust at the point of admission, FCMS’s UCC and subsequent surgery records after Mrs A’s operation.

18. The clinical records show Mrs A was seen in ED on 31 May 2021, by a triage nurse in the late afternoon. The triage paperwork details Mrs A having had abdominal pain for two days. She was listed as alert, uninjured and without chest pain, and her physiological observations were taken.

19. The triage nurse referred Mrs A to FCMS’s UCC eight minutes later. The Trust has informed us this is ‘round the corner’, and we can see when consulting a map this does form part of the hospital. Given this, coupled with the documentation reporting Mrs A as alert and mobile, we can see it was appropriate to refer her to the UCC rather than address her symptoms in the ED. This is because she had not suffered an accident and she did not present as a clear emergency.

20. FCMS’s records show Mrs A arrived at the UCC five minutes after being referred there. She waited a further 20 minutes to be seen by a GP. The GP reiterated the previous symptoms of abdominal pain and said this had been ongoing for three to four days instead of the two days recorded in the ED. The records show she was not nauseous or vomiting and did not have a temperature.

21. The records show the GP in the UCC went on to examine Mrs A and described her abdomen as soft, with no swelling. The GP details the areas in Mrs A’s abdomen that were painful and tender. The GP also took further physiological observations.

22. As part of our investigation into this complaint, we sought independent clinical advice from a GP with extensive experience in assessing abdominal pain. We asked our adviser to review Mrs A’s records along with the symptoms she presented with at the UCC.

23. Our adviser explained appendicitis presents with abdominal pain that begins in the central abdomen and moves over to the lower right. Mrs A’s abdominal pain did not follow this typical migration. Appendicitis also commonly presents with nausea, fever, raised heart rate and loss of appetite. Mrs A was not displaying any of the symptoms. Our adviser goes on to say Mrs A’s physiological observations all looked good and raised no concerns.

24. We asked our adviser whether Mrs A had been assessed within NICE clinical standards when in the UCC on 31 May 2021.

1. The Parliamentary and Health Service Ombudsman has carefully considered Mrs A’s complaint about FCMS, a health service provider. We recognise the events have caused Mrs A a lot of pain and involved a significant recovery period. We are deeply sorry to hear this. However, after careful review, we can see no sign that FCMS failed in its care.