Decision Report 201800001

Summary

Mr C complained about the care and treatment his late father (Mr A) received when he attended the emergency department at Monklands Hospital, after having been involved in a minor road traffic accident. The board concluded that Mr A had a soft tissue injury and he was prescribed paracetamol and ibuprofen. Mr A returned to the emergency department one week later reporting worsening symptoms. A further assessment was carried out and it was noted his international normalised ratio (INR - a measurement of how long it takes blood to form a clot) levels were high and fractures to his vertebrae and ribs were identified. Mr A's condition deteriorated significantly and he developed sepsis (a  blood infection) and discitis (inflammation between the discs of the spine). Mr  A died as a result of these complications. Mr C complained that the board failed to note that his father was taking warfarin (a drug used to prevent blood clots) and he should not have been prescribed ibuprofen. Mr C also complained that the fractured vertebrae and ribs were not identified during the first assessment.

We took independent advice from a consultant in emergency medicine. We found that the assessment of Mr A's symptoms was reasonable and an x-ray to inspect for fractures was not warranted. However, we considered that the prescribing of ibuprofen was not reasonable and other forms of pain relief could have been considered. Therefore, we upheld the complaint. We did not make any recommendations as the board had already taken steps to address this failing.