Medical complaint - is this correct?

[Stylemyhairplease]

In December 2020 I had an intravenous infusion which went wrong and has left me permanently disfigured.

In February 2021 I submitted an email to PALS asking a number of questions; I believed a formal complaint could follow. Every 28 days, I then received a letter apologising for the delay and promising a reply within 28 days.

Now, March 2022, I have received a response. It is inaccurate, unsympathetic and even rude in places ('I am sorry that you don't remember...' etc). Perhaps the most frustrating, it says this: 'if you remain unhappy with this, our final response, you can contact the ombudsman'.

But this is my only response? Plus, when I go to the ombudsman site, they will only take complaints within 12 months and this is now well outside that window.

Can I reply to them anyway? They have left so many questions unanswered etc. I am now even more angry about how I feel I have been treated. There isn't even an apologise for what happened

Go back to them with your questions. Is it an official complaint or investigation?

I just contacted PALS thinking that I would get further information and answers, and I was then planning to submit a formal complaint if needed. My GP even took photos 'in case you later want to sue'. It looks like PALS turned it into a formal complaint. But one reply, just outside the window for the ombudsman? It seems so wrong.

I think you need legal advice on this. You can still contact the ombudsman as they do deal with cases older then 12 months providing you have evidence and they can look into it. You can also complain directly to the nhs trust you are with and not just through PALS. If I were you and you have proof etc I would go down the medical negligence route with a lawyer and they should get it done quicker. Good luck. No one deserves to be let down the way you have.

Ime Pals would have asked you before referring as a complaint. Were your questions submitted previously or are they as a result of the report. Is it Duty of Candour incident or was what happened a known potential side effect?

This is my first actual response to my email to PALS. I didn't frame that as a complaint nor was it originally referred to as a complaint. This image below is from 6 weeks after the original email and it talks about my 'concerns'.

No previous investigation has been done. No response other than the 28-day 'holding' letters.

This is a known complication if the infusion is performed incorrectly. It is not a known side effect and will not occur if the infusion is done correctly.

Was it from Pals or the Complaints department?

I have just checked and yes, it must have been passed to complaints. The letter is signed by the medical director of the hospital and it was emailed to me by Complaints Investigation Manager – Medicine Division

I did send it to PALS though.

Should say, I don't actually want to sue. I just want an apology and an explanation of why proper procedures were not followed.
I have neither of those in this letter.

I would wait on any commitment about suing but if the letter is not an apology and gives no indication how procedures have been reviewed since your case to avoid recurrence in future go back to them. Read up about Duty of Candour and, if it feels relevant, ask if this has been followed.

Given they have responded outside timescales, I would state this as grounds to go to the ombudsman 'late'

I just can't really understand how one response can count as a 'final' answer? I just want some explanations and this letter doesn't provide them.

I think if I had been left permanently disfigured and then got fobbed off with a letter like that, I would be engaging a solicitor!

If you are in a union, you should get free legal advice, or I know some people have it with their home insurance. Even if you do not wish to sue, you need answers.

I think the Ombudsman may have special circumstances for delays.

You will not get an apology unless you take it higher. They all back each other and hide it. You have been left disfigured and all you want is an apology. That’s crazy.

I don’t have experience of whatever ombudsman applies here, but with the financial ombudsman they have a 6 month timescale from the date the business sends their final response. I would have expected the 12 month timescale you mention to have applied from the date of their response. Or if not, they should take the delay in PALs response into account and still allow your complaint given it’s out of your control.

I’m with @Meandthesky. I was also going to say that it’s usually from the date of the final response; not the date that you complained.

You have 3 years to make a complaint about the NHS - you can also get an independent advocate to help - these are free in most areas, and can support you through the whole process.

This sits outside the PALS process and any compensation claim you may wish to make - some organisations that provide this are independant advocacy charities such as Voiceability or Pohwer and there are others it all depends on what area of the country you are in.

Hey OP

I'm a manager in the nhs for medicine and respond to complaints like yours all the time. In my organisation at least it would work as follows:

A concern raised to PALS would not automatically be uplifted to a full complaint response unless you requested it and would involve a smaller, very quick investigation and informal response from the directorate manager of the particular area. However this is generally used for cancelled appointments, rude doctors etc. your complaint should always have been through the full complaint review and response.

A full complaint review gets sent to the clinical director for the area, matron and manager for the relevant areas who then begin an investigation involving any other departments involved etc. they would write a detailed letter in response and then that would be quality assessed by the complaints team before being quality assessed by the MD or CEO before being sent to you.

You can absolutely write back and say you don't feel your questions have been answered to your satisfaction and at the point of raising with pals you weren't aware it was being investigated through the formal process. Write a new list of questions, comments on their responses that you want responding to and resubmit that. They will have to redo the investigation. You can CC the ceo or md or your mp into it. This does happen.

I am so sorry for your experience initially and then the poor response you received.

Best of luck.

Thanks so much for the replies.

This is the ombudsman that the letter directs me to, and this does seem to suggest 12 months from the incident.

I think I will write back. I don't see how you can simply decide that this is a 'final response' without giving me a right of reply?

I doesn't look like it has been done along expected lines. There is certainly a fair amount of back-covering going on.

Can I ask for my notes covering that period?

As I said, my experience is with financial services so may not be very relevant.

But in financial services, the customer makes a complaint and after investigating the business sends a “final response”. Of course customers can and do reply and challenge or question things, but there isn’t a process of them sending a “draft response” for the customer to respond to before the final response is sent.

Fully appreciate medical things are much more sensitive though, and it does sound like communication has been very poor which I know compounds the original issus

You should be able to request your medical notes, if nothing else as a “subject access request”, although I would try a standard “please can you send me all records/notes/whatever else is relevant for the period x to y” first to save everyone time and effort, including you

@Stylemyhairplease

Thanks so much for the replies.

This is the ombudsman that the letter directs me to, and this does seem to suggest 12 months from the incident.

I think I will write back. I don't see how you can simply decide that this is a 'final response' without giving me a right of reply?

I doesn't look like it has been done along expected lines. There is certainly a fair amount of back-covering going on.

Can I ask for my notes covering that period?

You can submit a DSAR for your records. Information should be available on the website.

I’m assuming this is ferinject staining?

I forgot to attach the ombudsman image - sorry.

@FelicityBeedle

I’m assuming this is ferinject staining?

Not quite, no, but similar. The issue is that it was administered via a portacath so my entire chest is affected. The nurse didn't obtain a flashback before administration so it seems likely the needle was dislodged before we started.

@Ginfilledcats

Hey OP

I'm a manager in the nhs for medicine and respond to complaints like yours all the time. In my organisation at least it would work as follows:

A concern raised to PALS would not automatically be uplifted to a full complaint response unless you requested it and would involve a smaller, very quick investigation and informal response from the directorate manager of the particular area. However this is generally used for cancelled appointments, rude doctors etc. your complaint should always have been through the full complaint review and response.

A full complaint review gets sent to the clinical director for the area, matron and manager for the relevant areas who then begin an investigation involving any other departments involved etc. they would write a detailed letter in response and then that would be quality assessed by the complaints team before being quality assessed by the MD or CEO before being sent to you.

You can absolutely write back and say you don't feel your questions have been answered to your satisfaction and at the point of raising with pals you weren't aware it was being investigated through the formal process. Write a new list of questions, comments on their responses that you want responding to and resubmit that. They will have to redo the investigation. You can CC the ceo or md or your mp into it. This does happen.

I am so sorry for your experience initially and then the poor response you received.

Best of luck.

Thanks so much for this. I shall follow it every step of the way! I do feel I have been mislead and I simply want answers. I am wary of going down the legal route as I have a number of serious health conditions so I'm constantly in and out of hospital so I want to try and keep relationships clear and healthy. It is just frustrating as this reply is anything but!