To put in a complaint against NHS

[Vanillaisboring666]

My beautiful 14 year old dd attended hospital Tuesday last week to have her ACE stoma reversed . It was a simple 20 min procedure that was class's as day case surgery. We arrived at 8am and she went down to theatre at 12pm , arrived back onward at 1pm . At 230 pm she was discharged . She was un comfortable but managed to walk to car . Upon getting in car began to cry saying she was in a bit of pain . I got her home and into bed and gave paracetomol as per hospital instruction. At 4pm she was in agony and sweating. Took her to A&E as day case unit advised on phone they would be closing at 8pm . Anyways 2 hrs in a&e she was sweating , breathing fast and writhing in agony. After 2 hrs a paed doc came and gave oromorph and placed her on paediatric ward. She stayed overnight and was given regular oromorph but she was still In agony . The sister the next morning said it was post op pain and told me to take her home amd have a duvet day and give paracetomol. By this point she could not walk and looked gravely I'll with sweat running down her face. I took her home and once again tucked her up in bed. At 4pm wednesday (day after her stoma reversal ) she was in absolute agony so I called gp and he prescribed oromorp and we gave it her overnight. Thursday mornine she was unable to lift her head and gp advised over the phone i ring an ambulance . Ambulance arrived (after 1.5hrs) and she was once again took to a&e . A gastronsurgeon came immediately and she was then rushed to theatre . I was signing consent forms running along corridor. It was terrifying. Anyways she ended up having a full blown laparotomy after the attempt at doing surgery laparoscopically failed. She has 4 laparoscopically incisions and a huge vertical cut down her tummy from laparotomy and also a cut on right side of tummy from her ace reversal surgery and initial ace surgery. She has been through hell. She was on itu for two days and is now on ward but is still critically ill as having temps and heart rate fast. The surgeon who did the ace reversal was never informed dd was readmitted by the ward and has profusely apologised as he said this should never have happened. He is going to be looking into why he was not told dd was back in hospital with pain 4 hrs after his surgery and why the bloody hell she was discharged in such a terrible state the next day when she was very obviously seriously ill. She is so so so poorly now and is still critically ill amd at risk of sepsis . She will be getting ct scan tomorrow as nothing is bringing down her temps . I am furious she was made to suffer such pain for 48 hrs and has ended up needing full blown laparotomy. If her surgeon had of been informed on the Tuesday he said he could have managed to do surgery laparoscopically. Instead he said her abdomen was so full of puss and poo he had to open her tummy from top to bottom. I am heart broken and not coping well with seeing how much pain she is in. I am strong in front of dd but have to go to toilet amd cry every now and then. We have a huge long road ahead to get her better but I am now starting to realise just how appallingly she has been treat by the ward who initially discharged her. No doctor even examined her before discharge and the sister said it was post op pain amd to have a duvet day and paracetomol ? I can tell the hospital is shitting themselves as they rolling over me and dh now . Even my dds consultant has admitted this should not have happened amd has apologised . He came to see dd twice a day Saturday Sunday despite it being his day off. I pray to god she recovers as docs say she is still critical and may need more surgery amd to go back to picu if her temps don't drop. Sorry it's so long and I hope it makes sense. I'm in bits and can't believe our wonderful nhs could have gotten something so wrong. A routine simple procedure has ended up with 8 hrs of surgery ,paed intensive care for two days,severely in pain child that is bed bound ,catheterised and has no clue just how serious this situation is. Her whole abdomen was filled with puss and poo and her bowel had ruptured . According to ward sister though it was post op pain and all she needed was paracetomol and a duvet day. My dd is so lovely and never complains so I knew something bad was wrong but the sister said she knew best and discharged her ??? AIBU in going to pals ????

Wishing your daughter a full and quick recovery! Please do contact PALS, not just for yours and your daughters sake but for others that may end up in a similar situation x

Bed sores? Fucking hell - that's appalling.

Bed sores are not always preventable in all patients. The skin is an organ like the kidneys, liver etc and can 'fail' when people are very very sick or elderly. But your DD is young and fit. She should absolutely not be getting bedsores.

You must be exhausted OP. But, if you feel up to it, I would ring the medical director's office and tell his/her secretary that your daughter has already experienced seriously substandard care, you are concerned about her ongoing care and you want to speak to him/her urgently as you believe your DD is being put at risk.

Re. your latest post Vanilla, how devastating!

Vanilla, I am so sorry you're going through this.

Could your other children go to a gp, or a gp come and stay, just for a night. Your dh could then come and spend the night with you and dd, and you doze while he sees to her, helps her to the loo etc, and if anything medical happens, wake you? You do need to get some sleep, and your dh does need to do things for dd while she is in hospital at least to approciate how hard it is for you and to be able to do things for her when she gets home.

Sending you both love and strength. Your daughter has a wonderful mum. Please don't blame yourself for other people not doing their job properly. Be kind to yourself.

Roses sounds very clued up. I'd honestly accept any help she can give you. Whether it's phone hospital to advocate or help with complaint.

Just the bit about their lack of care meaning lifelong care and risk means this needs taking seriously.

Yes, it could be adhesions they want to keep an eye on. Scar tissue internally from the surgery, and they may want to keep an eye in case of any further abscesses forming. I'm not sure about any other issues causing the need for the stoma in the first place as well. But it's good they will be keeping a close eye on things. Hopefully with time they will get less frequent. With mine I'm still seeing them a few years later every year due to adhesions.

Ah lovely OP. You really have both been through it.

Please make sure you are looking after yourself too. My dd was in hospital for a week when she was 3 and a couple of weeks after she was discharged I ended up in a and e with 'renal colic'. Which they basically said could have been caused by not drinking enough and eating crappy hospital canteen foods. So make sure you take care of you too.

With regards to your dd as I said up thread dp had a perforated bowel and every complication possible following that. He is fine now. Stoma reversed and gone. Scars fading and discharged from the hospital. And he was 44 when it happened. Overweight, a smoker and drank far too much and had a history of high bp. So if he can fight back your dd can too.

Irrespective of any other action all of the following medical staff need to be reported to GMC or NMC as appropriate:
Surgeon who performed original surgery (if this had been done properly none of the events that followed would have happened)
A&E doctor and paediatrician who admitted patient to ward without calling surgeon to examine her
Doctor who agreed to discharge from paediatric ward without ever examining patient
Paediatric ward sister who phoned to ask doctor to discharge patient and presumably misled doctor into believing patient was not very sick
GP who prescribed oramorph to patient with obvious signs of peritonitis
The GMC and NMC should investigate whether these individuals are fit to practise. Given that they all appear to have missed a serious case of peritonitis such investigations are appropriate.

In the meantime sympathy to OP and DD. I do hope DD starts to feel better soon. From experience with my relatives it is a slow process, but a good recovery is possible.

Please don't take User1493630944's advice, OP. The last thing you want to be doing is wasting your energy firing off complaints about the world and his dog when there hasn't even been a preliminary investigation. That will not help you be taken seriously at all.

Something has gone very wrong with your DD's care and the hospital needs to be held to account. That does not mean that every doctor or nurse involved in her care has behaved wrongly. From what you have said there is no evidence that the original surgery was done badly - infection is a risk with any operation, especially on the gut which contains millions of bacteria. The A&E staff who sent your DD to the paeds ward ASAP were doing the right thing - it is usually better for children to get them out of the chaos of A&E into a child-friendly environment where they can be cared for by paediatric nurses. It is not the A&E staff's fault that the paediatrician didn't call the surgeons. And so on.

Basically, User1493630944 is talking out of her arse. Please listen to the much better advice that you have had from other posters. Focus your complaints at the moment on getting your DD the right care. There is time to complain about what has already happened once she is well.

Steady on, it's a bit of a leap to suggest that the original surgeon was negligent. All surgery carries risks, and any bowel surgery will carry a risk of failure, including bowel perforation. As long as the operation note detailed sufficiently the technique used, any difficulties encountered and the follow-up required, the surgeon discharged his duties.

The anaesthetist is responsible for the patient post surgery in the recovery room, and presumably there were no concerns raised by the recovery staff to prohibit return to the ward.

As for the ward sister, it's hard to know. If they used MEWS/NEWS scoring, it's possible that although she felt unwell and looked unwell, she didn't actually score very highly. A temperature would score 1 point, she may have had a high heart rate, scoring another point, but her blood pressure and respiratory rate may well at that point have been normal, so she wouldn't have triggered the warning zone. If asked for the score, the nurse would report the normal score and the doctor would not be alarmed. Young people compensate for quite some time.

Yep. Clued up for all the wrong reasons have been battling an incompetent mh trust to ensure my dd gets adequate support for the last two years.

Note everything vanilla, these trusts twist and wriggle.

I hope you both have a better night x

This is why we hired a lawyer to handle our complaint. If you can't afford a lawyer just call your MP. The fact your DD has bedsores is inexcusable. What the heck you were doing unplugging machinery without anyone saying anything is beyond shocking. Here in the US if you unhook a machine a million and one alarms go off. The nurse would be running in right away.

You are clearly exhausted. I hope you are able to see an improvement in your DD and get some rest.

I would suggest that Lougle is giving advice more in line with what I would suggest. Let's not get carried away here.

Suggesting legal action is a huge and ridiculous leap. I am sorry your daughter has gone through this, and its one thing to raise it with PALS or in writing oterhwise, but really quite another to think it's possible to pursue a claim for this. It wouldn't be (thankfully) as a. Causation unproven - though perhaps an omission when sent home from A&E, b. Damage - hopefully no lasting damage despite this setback and the award for pain suffering and loss of amenity would not make it worth anyone's time at all, nor would any decent firm take this on. Talk of lawyers is completely inappropriate at this stage in my view. I wish all the best to you and your DD and a prompt as-satisfactory-and-transparent-as-possible response to any issues raised with the hospital if you do choose to complain.

I dont mean to sound dismissive. What you've been through is very traumatic and upsetting and has caused your daughter more pain. However as others have said, this does not mean any aspect of the surgery was negligent and it certainly would be inappropriate to consider legal action now, or to consider reporting anyone to the GMC/NMC. Allow the investigation to occur at a local level as to why she was sent home and ask to be kept informed. This is surgery with a myriad of complications but the existence of a complication does not mean it was negligently performed.

No, legal involvement is absolutely not a ridiculous leap. leghoul, how can you possibly say there is no lasting damage? OP has said her daughter is looking at having to have three monthly check-ups for the rest of her life, and she has a lifetime risk of bowel problems. Just stop and think about facing 70 years with constant recurrent bowel problems, for goodness sake. This will inevitably affect her education and her long-term career prospects, to say nothing of her ability to enjoy life normally.

And how can you possibly say causation is unproven? If the medics had reacted as they should have done to the first report of pain after surgery, this could have been sorted out quickly and relatively painlessly. For goodness sake, they prescribed painkillers for a post-op child who was sweating, breathing fast and writhing in agony! As a result, OP's daughter was left for several days in increasing severe pain, and reached a point where the illness was life-threatening and required major surgery not once but twice.

To say nothing of the bedsores which simply should not ever happen in a competently run hospital ...

Leghoul i know a few law firms that could use your assistance. It usually takes years, several prominent experts in different medical fields, witness statements, files of medical records and many meetings to establish breach and causation but you seem able to nail it just from an mn post! Amazing skills
Instead of being quite so dismissive of this poor girl's right to question and investigate her treatment in the years to come, perhaps you could leave it the OP to explore her options with professionals when the time is right?

leghoul What you have said makes no sense.

It's clear the surgeon should have been alerted much earlier. The surgeon isn't at fault but everyone else who dismissed this girl needs retraining at the very least. You honestly sound like the idiot at PALS I had to deal with who told me that my father at 72 shouldn't expect the NHS to fund him living forever. When I picked my jaw up off the floor and challenged this statement I got an equally astounding comment of 'Since you have the money for a lawyer you have the money for private care. I suggest you people do that.' The lawyer was dumbfounded that anyone could be so ignorant.

Oh OP I'm so sorry to read your latest updates.

I hope that they have come a fully documented your DDs pressure sores? They also need to be Datix'd and reported as separate SUIs. It sounds like the main cause of them, in addition to not being moved (and don't feel guilty about that - we don't usually associated pressure sores with young girls), is that her nutrition will not be good right now. I think you mentioned that even prior to all this her eating wasn't good and that she was only on IV fluids initially, no nutritional/vitamin infusions? This will all have an effect. Has the Dietician been called to see her? Ideally she needs something like fortisip or other meal replacement if she can't eat right now.

Frankly I'm amazed she's even attempted to eat this soon, she is a fighter. I had major GI surgery at 16 that also went wrong (an undetected bleed in my case, I nearly bled out before they found it) and I was not allowed to eat solid food for almist a month - it was December and I had to have my Christmas dinner blended into soup. I wasn't given any nutritional support and along with medication errors my weight plummeted to 6st. When I returned to school people thought my op was a cover story for being in rehab for anorexia!

However, I'm happy to say that although it was a dark and scary time I obviously made it and nearly 20 years on I am OK (barring other chronic illnesses that I had all along), I'm even a bit overweight now!

I couldn't have got through it without my DM and DF though. I can imagine you're in the same position they were in all those years ago.

Be polite but very very firm - they need to give you a very clear and detailed plan of how they intend to help DD. Ask to go through her notes with someone appropriate if you can. You can also ask PALS to facilitate a 'debrief' session for you and DD after the event, possibly with the surgeon responsible for her care.

Finally, speaking as someone who went through similar, when this has calmed down and DD is definitely getting stronger, you must request that she is provided with some counselling. It doesn't have to be loads, just a chance to talk and process all this. Don't let them fob you off or tell you you have to go privately for this - she will need a counsellor or psychologist trained for this kind of thing. If they say they don't have anyone, then you must ask that her consultant makes an urgent referral to someone in the local community mental health trust. It is the least they can do for you in all this. You may find that you need some sessions too. Even if you feel you only need one or two, DD/you will benefit from them. It is something that wasn't provided to me and I really needed it as for the first few years I was pretty messed up, and to this day I still feel very down at that time of year, even if I don't notice the date at first. There is definitely some PTSD there.

Please keep us updated how DD is doing.

Want2b I'm absolutely astounded someone in PALS would say such a thing. If that had been said in my department they would have been hauled over the coals and severely disciplined, if not sacked. PALS are meant to be there to help, and the departments I've worked in have always stressed the need for compassion regardless of personal views. I'm so sorry someone said that to you, it's disgusting.

"You honestly sound like the idiot at PALS I had to deal with who told me that my father at 72 shouldn't expect the NHS to fund him living forever."

What on earth was meant by that? My husband is 70 so I'm very interested in exactly what this person was saying and the attitude behind it.

Rhonda Good glad to hear other trusts are being properly run. We had been very nice and professional with our complaint of my father being ignored up to that point but it became very clear that PALS was covering for the hospital and this lady was defending the indefensible.

Banff I am from the NW, very close to Liverpool. I told the lady that just because we were close to Liverpool didn't mean the Liverpool pathway was a treatment option.

In all seriousness the management at the trust clearly do not care about anyone over 70. They are expected to accept low standards of living. My father had no physio when it was clear he couldn't get his socks on. I was told that I would have to hire someone to come to the house to put his socks on in the morning. I told them I needed a number for a private physio and they said it was cheaper to hire a care worker. My dad doesn't want someone putting his socks on for him. I found someone for physio and he has been doing it three times a week for the past year and he is back to riding.

Our MP has been amazing. Labour man but very very good and cares. Ironically the Tory MP in the area where the hospital is located is excellent too.

And talk about sandwich generation. In our family we have my Dad, SIL and BIL who are all very ill. My BIL probably won't make beyond the end of the year. We also have 3DC ages 6 and under (it's my eldest DC birthday today!) plus we both work FT and run two businesses on the side.

The flying back and forth (we live in the US for DHs job) is an absolute killer and I'm home once a month to ensure he isn't getting messed around. You have to be on them all the time. It's exhausting.

Please complain before they 'lose' your notes! I complained, for something less serious, and they couldn't do anything as my notes had been lost 😞