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Case ref:201700711
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Date:March 2019
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Body:Ayrshire and Arran NHS Board
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
Miss C complained about the care provided to her late mother (Mrs A) at University Hospital Ayr. Mrs A was receiving dialysis (a treatment which mimics many of the kidney's functions). Miss C complained about the care provided to her mother in relation to an arteriovenous fistula (a blood vessel created in the arm for transferring blood into the dialysis machine and back again) following a dialysis session. Miss C considered that the interruption in her mother's normal dialysis routine as a result of the fistula problems impacted on her renal (relating to the kidneys) care and her overall deterioration.
We took independent advice from a consultant physician with experience in dialysis. We found that the care provided in relation to the insertion of the needles at the fistula was reasonable. We found that the most likely cause of extensive bruising to Mrs A's arm was caused by a pseudoaneurysm (a collection of blood that forms behind the two outer layers of an artery) behind the fistula and that the cause of the bleed was difficult to determine.
We also found that, given the condition of Mrs A's arm, the decision to the continue with dialysis using a permcath (a type of venous catheter) was the most appropriate treatment option and that there was no unreasonable delay in changing to this option. We found that the interruption to Mrs A's normal dialysis routine as a result of the fistula problems did not impact on her renal care and her overall deterioration.
We did not uphold Miss C's complaint.