Source · PHSO decision

A practice in the East Riding of Yorkshire area

Ref: P-002364 Statement Decision date: 15 December 2023 Jurisdiction: NHS in England Closed After Initial Enquiries

Mrs R complained her husband's GP failed to examine or refer him for tests two days before his death, potentially preventing pneumonia and a heart attack.

Outcome

AI summary
The ombudsman closed the case, advising Mrs R that she could pursue legal action regarding the circumstances of her husband's care.

The complaint

4. Mrs R complains about the Practice’s care and treatment in May 2023 saying:

• the GP did not do any physical examinations on her husband when he was very unwell two days before he died

• the GP did not refer her husband for more tests.

5. Mrs R says if the GP had properly assessed her husband he could have been prescribed medication to prevent pneumonia (inflammation of the lungs) which led to a heart attack. She says she is distressed because she lost her husband suddenly and unexpectedly. Mrs R says she has been left unable to cope financially.

6. Mrs R wants a financial payment of around £10,000. She would also like an apology and service improvements.

Background

7. Mr R had been in hospital at the end of April 2023 with a chest infection. During the first week in May, Mrs R felt her husband did not seem himself. She says he did not look well at all and seemed confused. She took him to the Practice to be assessed by the GP. She says the GP focused on his mental health rather than this physical health. Mrs R says two days later she had to call an ambulance because her husband’s breathing had become difficult. She says the paramedics took one look at him and asked if he was getting end of life care. Mrs R says she was shocked.

8. The paramedics assessed him and advised he had a very high temperature. Mr R had a cardiac arrest (heart attack) while the paramedics were trying to get him in the chair to take him downstairs. The paramedics did CPR and were able to make him stable enough to take him to the emergency department. Mr R sadly died later that day from a heart attack brought on by severe pneumonia.

Findings

10. The Health Service Commissioners Act 1993 (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 in the circumstances. We discussed this with Mrs R to understand her circumstances and the outcome she wants. We do not consider whether legal action would succeed, but whether it would be a reasonable option to look in to.

11. Clinical negligence takes place when a patient who had treatment becomes injured as a result of that treatment. Failure to give appropriate treatment could also amount to negligence.

12. We do not consider financial payments in the same way as a court does. A court would be able to consider and assess an appropriate amount of compensation for the impact Mrs R describes. We would not want to disadvantage Mrs R by investigating the complaint when it would be more appropriate for her to go through a legal process.

13. We discussed any barriers Mrs R may have to taking legal action. Mrs R advised she has already spoken to a solicitor who advised her to bring her complaint to us first. We advised Mrs R we do not investigate when there is an available legal route unless we see good reason to. We advised Mrs R to get the opinion of different solicitors.

14. Mrs R told us there are no barriers to exploring her legal options on a ‘no win, no fee’ basis. Mrs R says without this, she would not be able to afford legal action.

15. We told Mrs R if there are any outstanding concerns that cannot be achieved by a legal claim, or if she finds she is not able to make a legal claim, she can bring the complaint back to us. We told Mrs R about our time limit.

16. We thank Mrs R for bringing her complaint to us for consideration.

Our decision

1. We have carefully considered Mrs R’s complaint about a GP practice in the East Riding of Yorkshire area (the Practice).

2. We are very sorry to hear about the death of her husband, Mr R. We understand how difficult this has been for Mrs R and how she is left with unanswered questions about his care and treatment.

3. We think Mrs R could take legal action on the matter she has brought to us.

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Decision details

Reference
P-002364
Decision type
Statement
Jurisdiction
NHS in England
Decision date
15 December 2023
Outcome
Closed After Initial Enquiries

Complaint summary

AI
Summary
Mrs R complained her husband's GP failed to examine or refer him for tests two days before his death, potentially preventing pneumonia and a heart attack.

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Data from PHSO under Open Government Licence.