To make a complaint to PALS

[ElseaKnowsBest]

Recently me and my DH took DS to hospital. He had been unwell for a few days and had deteriorated quite badly. His temperature was high, he was not eating or drinking and had gone floppy. (No wet or dirty nappies either). We had been giving him dyoralite and regular paracetamol and ibuprofen. Nothing was working and after ringing 111 we ended up in A&E. The doctor looked at his OBS said his heart rate was very high and his oxygen wasn't as good as it should have been. They wanted to observe him and needed a urine sample. 12 hours later his heart rate was a bit lower and oxygen had improved slightly. We got told it was a viral illness and to go home. "Keep doing what you're doing". I was called a paranoid mother because I said he still seemed really poorly. I asked if they could take his blood. Doctor said no. 3 days after that he was unresponsive and was rushed to a specialist hospital. We got told it was severe dehydration. My husband went with him, I dropped my DD off at school and made my way to hospital. When I got there my son was in a resuss room surrounded by doctors. His x-ray results showed he had pneumonia in his left lung. His veins had collapsed so they had drilled into his shin bone to get strong antibiotics into him as he also had sepsis in his legs. The doctor told me he was in critical condition. Once stable he was taken to the great north children's hospital. The antibiotics weren't doing enough and he had an empyema and needed surgery. The surgeon took all the infection out and he had a drain in for 4 days as they had found an abscess in his lung. 14 days in hospital and he's back home. He lost muscle mass in his legs and has had to learn to balance again.
I'm angry at the original doctor as he failed to grasp just how ill my son was. If he had taken blood he might have found the infection in his blood. My 18 month old baby nearly died! I keep thinking about it. It's put dampener on Christmas and I'm struggling. The health visitor has been lovely and has given me tips about how to build him back to a healthy weight.
AIBU to make a complaint to PALS about the first doctor? Or should I accept that limited resources and pressure on doctors meant he did all he could at the time?

My dd was very unwell as a baby - it all went on for a lot longer than would have been necessary had the consultant we saw looked at her properly instead of bullying a student, who was observing the appointment. He just assumed he symptoms pointed to the most obvious thing and she was misdiagnosed. If he'd sent her for the right tests straight away she could have avoided a couple of intensive care stays and had the surgery she needed earlier.

I didn't complain. Maybe, from the point of view of learning from mistakes, I should have. But from a personal point of view, for our family, I wholeheartedly did not want to. She survived, she is 7 now, thriving and having a lovely life. Dragging that doctor through the mud and going over everything again would not have achieved anything imo. He is obviously an intelligent man and knows he made a mistake with dd.

I know not everyone feels like this though - you must do what feels right for you.

You should definitely complain. The paranoid comment was inappropriate and you were right to question the lack of progress/discharge. If you don't complain, how will this clinician learn to provide better care and how to listen properly to a worried parent with legitimate concerns?

My DS had hand, foot and mouth two weeks before this incident with 4 admissions to a walk -in service and GP as he seemed ill for quite some time. That was the reason I called 111 the second time. I didn't want to just turn up to A&E.

I can understand the doctor probably called me a paranoid mother because he's probably dealt with many pushy parents that evening but I had been dealing with a very poorly boy for weeks at this point (previous hand, foot and mouth) and felt like I was going mental. I almost didn't take him back to hospital because I was convinced by that doctor it was a viral illness!

littlepeas I'm glad your DC had a good outcome but you have absolutely no way of knowing if what happened with this doctor was a one off or part of a pattern of behaviour. It's not 'dragging a doctor through the mud' when you make a complaint. There are processes in place for proper fair investigations. You don't know he learned anything or what he's done since. Your opinion that nothing would have been achieved is absolutely invalid I'm afraid and somewhat arrogant unless you have much more knowledge of his professional fitness to practice than you are posting. I know I sound harsh but I had 8 years involvement in medical fitness to practice work and I saw much evidence of long standing inadequate to dangerous patient care that would have been avoided if someone had complained earlier - often the complaint only happened after there had been a death.

Dragging that doctor through the mud and going over everything again would not have achieved anything imo. He is obviously an intelligent man and knows he made a mistake with dd

I think it very much depends on the circumstances though. I was ill in the summer on HDU. The Doctors were stretched beyond belief. That much so they couldn't deal with me when I got worse one night as they were too busy dealing with a patient on NIV. By the time I'd been moved to a different hospital that afternoon, with the same docs in the morning telling me I'm just working hard to fight off whatever virus I'd picked up on top of my chest infection, I was sending the new doctors into a flying panic because I was showing signs of sepsis. I felt extremely poorly so cant imagine how poorly OPs DS, a very young child must have looked. They shouldn't have dismissed her concerns. I never complained as that was down to staff shortage etc. I complained this time around because despite paramedics telling the Dr they were concerned, and the other nurses telling him the same, he arrogantly sent me home, only to see me be rushed back in in an emergency situation again. A Paed Nurse once told me on one of DDs admissions that she always listens to Mums. Their instinct is there for a reason. As OP has proved in this case.

If OP doesn't complain, this wont be raised as an issue at all and the doc could go on still assuming that every other baby he meets like OPs DS must also have a paranoid mother too. Complaints are also so they can see where they made mistakes too and learn from them. It will help this Doc not make the same mistake again.

What's a pushy parent in this context? Does it mean a parent, who knows their child better than anyone else being concerned about their child and the symptoms exhibited?

What were his actual, verbatim words when he called you a paranoid mother? I mean was it actually, "You're a paranoid mother?" or are you paraphrasing?

I'm not asking because I don't believe you, but because I think it'll make a big difference to their response to the complaint.

I have twins and I have been in hospitals many times with them. Sometimes maybe I am the paranoid mother.
But the doctors have all says the mother is right and to trust your instincts
Therefore I would complain. The next mother being told that may decide not to go back or get treatment and dearly knows what could happen
I have complained once, I ended up my chance meeting the chief boss in the hospital and I was mainly complimentary but I did have to mention something which had happened and was stupid policy. She said she would review it. Made me feel tonnes better and hopefully next twin mum won't have the same problem

"You are a paranoid mother"
Because I asked for him to have blood tests because I wasn't convinced he was any better.

Yes do complain to PALS and hope they do a RCA-- root cause analysis. Make your letter very factual and if you can remember names include them in there. Also put an established timeline.

PALS as soon as you feel up to it. Arrogant shit. No excuse for calling you paranoid. Apart from the serious failure here, the doctor is not medically qualified to diagnose paranoia because he/she isn't a specialist. Shouldn't bandy about terms like that if not qualified to say it. Obviously you are not paranoid, you are being a responsible parent.

I agree- PALS can instigate an investigation and at least any mistakes made will be learnt from. I hope your DS makes a full and speedy recovery.

Yes, do complain! You could be one of many "paranoid mothers" this doctor has failed.

So sorry you went through this, you must have been so scared

And the trick is to be methodical and dispassionate. Names, chronology etc etc. The NHS struggles to answer clinically presented arguments and can more readily fob you off if you are emotional about what is obviously a distressing and emotional subject.

Please complain!

I would complain to PALS for sure. I work in a hospital and have seen how thoroughly they investigate a complaint - asking loads of really good questions that are relevant and should hopefully identify what went wrong and you would also (hopefully) get a proper apology for how the doctor spoke to you. It might not have been possible to spot it earlier - I am not a medic and none of us was there - but it was definitely possible not to patronise you and make you doubt yourself so much that you left it another 3 days to return.

I am glad he's on the mend .

Firstly, I am so glad he is recovering. You have all been through a lot .

Secondly, I think it is really important that you raise this matter with the hospital. Irrespective of the unkind and unprofessional comment that was raised, requesting a review and investigation of the case could save another child's life if the hospital teams are able to identify an improvement to their practice from what happened in this case. That is really really important, and worth stressing in your letter as a reason for contacting them.

I'm a nurse and I would say complain. It will lead to an investigation and they will possibly find seasonal pressures, or possibly lack of knowledge/experience on the part of the doctor, but either way it will show a 'near miss' incident and lessons can always be learnt. I think more people should complain, so that management can investigate and if they keep finding the same outcome it gives proof to change things.

So sorry you've had this experience. Hope your baby is making a good recovery x