An elderly patient should have been given more time to consider the implications of undergoing a risky hospital procedure before giving her consent, the Ombudsman has ruled.
But a complaint about the actual care and treatment received by the woman, identified only as Mrs Y, has been rejected.
Mrs Y’s daughter lodged the complaint following her mother’s death at Glan Clwyd Hospital on August 12, 2015.
She was admitted to hospital on July with abdominal pain and abnormal liver function, and a scan revealed she had gallstones and a blockage of the bile duct.
Consultants decided to carry out an ERCP, a procedure involving an endoscope, or lighted tube, being inserted to examine the pancreas and bile ducts.
During the procedure Mrs Y suffered a perforation of the oesophagus and was considered too frail for corrective surgery.
Her daughter – Mrs A – asked whether her mother had been appropriately assessed for the procedure bearing in mind her poor physical condition, her general health and age. She said her mother had suffered severe discomfort and pain as staff tried to remove the camera.
Mrs A also complained about the pain relief treatment her mother subsequently received, but after obtaining professional independent advice the Ombudsman’s investigation officer Layla Hoque did not uphold that complaint.
She found that the care provided to Mrs Y was “reasonable and appropriate” as her condition would probably have deteriorated had she been left untreated.
Mrs Y had signed the consent form, but only on the day the procedure was to be carried out – and that, according to Ms Hoque, was not enough time to allow her to digest the information.
“Given that Mrs Y was an inpatient at the hospital there was no reason in my view why preliminary consent could not have been obtained from Mrs Y before the day of the procedure,” she said.
“This would have given her more time to refleft, especially as the information was complex and involved significant risks.”
That particular complaint was upheld, as was Mrs A’s complaint about the delay by the Betsi Cadwaladr University Health Board in responding to her. The response was not received until June, 2016.
“The significant delays amount to maladministration and added to Mrs A’s distress,” she concluded.
The Board has apologised to Mrs A and agreed to pay her £250 for the distress caused.
In addition, the Ombudsman called for clinicians to be reminded of their duty to carry out consent processes “in accordance with Good Surgical Practice Guidance”.
See full story in the Free Press