Decision Report 201508344

Summary

Mr C complained to us about the care and treatment provided to his mother (Mrs A) at Dumfries and Galloway Royal Infirmary before her death. Mrs A's GP had referred her to hospital. At that time, she had end stage kidney failure, but did not want dialysis (a form of treatment that replicates many of the kidney's functions) for this. Mrs A died four days later and the cause of death was recorded as pneumonia. It was also recorded at that time that Mrs A had deteriorated despite antibiotics and that her kidney function had worsened. Mr C had subsequently complained to the board about the care provided to Mrs A.

We took independent advice on Mr C's complaint from a medical adviser who is a consultant geriatrician. We found that although it would have been better to carry out an x-ray on Mrs A on the night she was admitted rather than waiting until the following morning, this delay did not alter her treatment. It would, however, have given the clinicians and Mrs A's family more information about her condition. We also found that Mrs A had been able to make her own decisions and had expressed strong wishes that she did not wish to be subjected to cardiopulmonary resuscitation in the event of a cardiac arrest. Although the form confirming that she should not be resuscitated had not been countersigned by a senior doctor as required, the senior doctors had recorded their agreement with the decision in the notes.

It is difficult balance between very active care to keep patients alive and then switching to palliative care once it is clear they are dying. We found that, overall, the care provided to Mrs A before her death had been reasonable. We did not uphold Mr C's complaint.