Decision Report 201701995

Summary

Ms C, an advocacy and support worker, complained on behalf of her client (Mr A) about the care and treatment he received at Ninewells Hospital. Mr A suffered an injury in which his fingertip was severed at the joint and he wanted to have surgery to have it reattached. However, he was referred for terminalisation surgery (where the finger is shortened and the remaining soft tissue is used to cover the amputated finger stump) instead. Following the surgery, Mr A experienced severe pain and his injury did not heal as quickly as he had hoped. Ms C complained that the board failed to provide Mr A with appropriate medical treatment and that nursing staff failed to appropriately assess and manage Mr A's pain before discharging him home.

We took independent medical advice from a plastic and hand surgeon, and from a nurse. The plastic and hand surgeon adviser considered that terminalisation surgery was the appropriate treatment for Mr A's injury. They explained that the outcome of reattachment surgery was likely to be poor and had higher risks than terminalisation surgery. Therefore, we did not uphold this aspect of Ms C's complaint.

The board accepted that Mr A's pain was not assessed and managed by nursing staff prior to his discharge and apologised for this. They explained that action had been taken to ensure learning from this case. The nursing adviser considered the nursing care was unreasonable so we upheld this aspect of Ms C's complaint. We asked the board to provide evidence of the action they have taken.