University Hospitals of Northamptonshire NHS Group

4. Miss A complains about the orthodontic care her daughter, E, received from the Trust between 2018 and 2020.

5. Miss A says: • push coils put on her daughter’s brace caused disfigurement and discomfort • the Trust failed to notice and remove the coils before lasting damage was caused.

6. She says the impact on her daughter includes: • considerable discomfort • disfigurement of her jaw • bullying • loss of confidence • loss of ability to play the flute.

7. As outcomes, Miss A wants: • an apology • service improvements • compensation for distress and pain.

8. E had a brace fitted in April 2018, to which push coils were added in November 2018. Miss A says this has caused an overbite disfigurement which will need surgery to correct.

10. The law says we cannot investigate a complaint where a person has (or had) the option to take legal action, unless we consider this is (or was) unreasonable. We have discussed this with Miss A to understand her circumstances and the outcomes she wants. We do not consider whether legal action would succeed but whether it would be a reasonable option to look into.

11. Miss A says her daughter, E, had a brace fitted in April 2018, to which push coils were added in November 2018. She says these caused E to suffer from discomfort and her jaw was deformed with an overbite. She says the orthodontist failed to notice the damage and remove the push coils in time to prevent lasting damage.

12. Miss A says E has been bullied because of this disfigurement, which has led to a loss of confidence – especially about going out among other people – and to treatment for depression and anxiety, with counselling and medication. She also says the disfigurement, bullying and, most recently, an operation to fix the disfigurement, has happened at a very vulnerable stage of E’s development and had a major impact on her self-esteem.

13. She adds that E has lost the ability to play the flute due to the change in her jaw, and this has had an effect on her education, although at this point it is unclear how much, as she is working for her A levels.

14. In discussions with Miss A she has advised that, in addition to an apology for failings and service improvements, she believes financial compensation is appropriate due to the long-lasting impact on E’s mental health and development.

15. Miss A feels it is hard to name a level of financial compensation she feels is correct. She says level 5 or 6, on our Severity of Injustice Scale (£3,000-10,000+) is appropriate, as she says the injustices suffered have been life-changing for E. This is because she must undergo an operation, she has lost her hobby of playing the flute, and her education has suffered, but they do not know the true extent of damage done as her A levels are pending.

16. Having discussed the outcomes with Miss A, and after her discussions with her daughter, she has confirmed a financial outcome is her primary motivation. We are more suited to achieving service improvements than the legal route. But this, and apologies, can potentially be secondary outcomes resulting from a successful legal case.

17. Following legal action, we would potentially be able to consider issues and outcomes not covered by the legal case. Bearing this in mind, it seems prudent to focus on the key outcome she wants at this time.

18. If she is unsuccessful in this, Miss A may come back to us to pursue her complaint. We could look at whether we could reopen the complaint at that stage. We have advised Mrs of this. Our time limit would still apply if she did need to re-approach us. It is important she does this quickly if she needs to as we can only put this to one side if there are good reasons to explain any delay.

19. The legal route may be able to offer financial compensation, and this may be above what we can achieve, and Miss A is willing and able to pursue this route. The window of opportunity for this is limited. To make sure she is able to make an informed decision on whether this is the right route for her, it is reasonable for her to explore the legal route now.

20. We think it is reasonable for Miss A to explore the possible legal routes available to her, so we have decided we should not investigate this complaint further at this time and to close the case.

1. The Parliamentary and Health Service Ombudsman has carefully considered Miss A’s complaint about University Hospitals of Northamptonshire NHS Group (the Trust). We are sorry to hear about the experience E, Miss A’s daughter, had and the challenges she faces. We recognise Miss A has been through a difficult and distressing time.

2. We consider Miss A could take legal action on the matter she has brought to us on the grounds of clinical negligence.

3. The law says we should not investigate a complaint if a complainant has (or had) a route to take legal action, unless it is (or was) not reasonable to expect them to pursue this.