NOT to make a formal complaint to the hospital

[anothercoldcupoftea]

A bit long, sorry.....

Last weekend our 2 year old DD1 had breathing problems (asthma/viral wheeze), my DH took her into A&E and got sent straight home again with advice to come back in 48 hours if still a problem.

Now, we'd had the same problem/symptoms 2 months ago and she had been given treatment (nebuliser/steroids etc). This time round we had also been using a reliever inhaler at home and it had stopped helping, so I knew she needed some extra help and was absoluitely astonished when they came back home again so quickly. She was clearly wheezy and struggling. However, A&E had said she was fine and of course you believe what the docs tell you (won't be doing that again), so we dillied around for a few hours, calling the GP (it was a saturday), and finally a nurse from the surgery rang to check on us (thank goodness) and could hear how bad DD1 was over the phone, so told us to go back to A&E.

This time round, much panic, and took 3 hours to stabilise her, basically only responded to the level of drugs pre the ventilator stage, then in the high dependency unit for 2 nights (great fun when also trying to BF and keep happy a 5 month old baby). DD1 is home now and doing well and getting far too much attention .

After a few discussions after the event, the doctors have clearly admitted to us that the initial response was incorrect and she should have been at least kept in for observation, and they have spoken to the doctor concerned, and will look at tightening up procedures to make sure a similar situation doesn't happen again. I'm happy with this (well, as happy as you can be when incompetence could have killed our daughter, and heaven help me if I ever see that particular doctor again, but I'm trying not to dwell on that).

But my DH wants to make formal complaint as well. I can't see what could be gained from this really. Maybe this is more of a what would you do, but am I BU to leave it as it stands and not make a complaint?

I don't think YABU, but I think a formal complaint will probably help to ensure that this doesn't happen again.

What a horrid experience though.

tbh You already have what would be a very good outcome from making a formal complaint so I don't see the point of doing it. Doctors are human and make mistakes - it's the ones who don't accept that who are a risk. IMO it's better to keep things between doctors without getting management involved, because they never do any good. YANBU

You have discussed it with them informally and they realise where they've went wrong and admitted it. If however they didn't admit they were in the wrong, then I'd be putting in a formal complaint to make sure the same thing didn't happen to someone else in the future.

I am glad your DD is recovering at home now and that everything's ok. It must have been very scary for you and your DH

Tricky. The main thing is that it's going to be addressed of course, but will your DH be frustrated if you stop him doing a formal complaint. Maybe he really feels he needs to. It sounds like a very frightening experience.

actually, i thikn this is the sort of situation that you do need to make a formal complaint, so this sort of ''near miss' can be formally addressed , why don't you want to ?

glad your DD is ok . i am sure that you are relieved , but it could have been a lot more serious, and that needs addressing

medical staff are aware when they've boobed and usually make sure that it never happens again, that's why they 'practice'. We all make mistakes and the fact that they were able to admit they were in the wrong openly, suggests they won't be making the same mistake again.

However if it really does put your DH mind at rest, then doing writing in to formally complain wouldn't do any harm either. the main thing is that you know yourself the medical staff realised they did wrong and have corrected themselves now.

I think you should do what ever you want too.

My experience of incompetance in a hospital led to me having to have surgery I wouldn't ordinarily have needed, made future pregnancies and labours very high risk and also meant we couldn 't have the amount of children we would have liked. Some people said we should have sued. We definitely had a very good case and I am sure we would have won but what was important was our baby was born and is now well. I am still cross when it comes up but suing would have been too hard.

YANBU if it is what you want.

I hope your DD is soon fighting fit.

I can see why your dh would want to make a complaint, tbh, but I can also see why you maybe feel its unecessary. Maybe your dh could write a complaint, but include the fact that once they realised their mistake, you felt they dealt with it well. THis way, a complaint goes on record for future training, but you also acknowledge that it was (eventually) dealt with appropriately

Im not sure what the point would be in making a formal complaint, as it sounds that your verbal complaint has achieved what you would want it to anyway.

Thanks everyone (and thanks for the good wishes as well - DD1 is pretty much back to her normal lovely self now ).

Some good points for me to think about....

Why would I not want to make a complaint? good question, I think just because it was such a horrible experience I want to put it behind me and not have to relive it all over again when writing it down; but then that might help I suppose.

Also agree that its important to make sure that everything is done that can be done to prevent the same happening again, and making it formal should achieve that. Not sure if it'll go on this doctors record otherwise. However, I like the idea of making it a 'nice' complaint and acknowledging what they have done well, as well as the initial problem.

Still not sure though - will show this to DH so we can chat about it.

... I think, reading Fab's post has reminded me (sorry to hear of your experiences Fab), that part of the problem is that I've experienced so much incompetence already at this hospital through my two childbirths there (which almost did for DD1 (again) when she was born, and meant I still have to go back for surgery, after DD2's birth 5 months ago, when I've stopped BF), that I just mentally try to block the hospital's existence out....

To be honest I don't think that making a formal complaint will make any difference. I've had a formal complaint made against me and it didn't go on my record.

I know other staff who have also had formal complaints made against them and again its not gone on their records. I know of plenty of instances where no complaint has been made but other staff are aware of an incident and an incident form has been completed and stuff has sometimes been put on record, sometimes not. Its basicly up to your boss to think if its some sort of negligence or an honest mistake. If its a repeated thing or a one off.

It sounds like the more senior Drs are aware of what's happened and have taken whatever steps they feel appropriate with that Dr. Whether this be a chat with him about where he/she went wrong or some sort of note on their record. If they're talking about tightening up prceedures then it looks like they've realised that their protocol isn't adequate rather than the Dr.

I also don'tthink that having something on a Drs record is the only way of making sure it doesn't happen again. I've made the wrong call sometimes (thankfully without serious consequence) and there is nothing worse than realising that. I've gone home and sobbed for days sometimes about decsions I've made/things I've not done. I haven't needed an official complaint to make me not do it again.

I'm glad your DD is ok, must have been very scary.

Glad your daughter is better.

If they are going to look at tightening up procedures they may have filled in an incident form. I'm not sure what a complaint would add to this. However, I can understand why your DH wants to put something in writing (obviously also why you don't.)

I wonder if a halfway measure could be to write to the consultant regarding the care, and say that due to the fact they have spoken with the doctor concerned and will be tightening up procedures you will not be complaining. Thereby you have made a point, and have something in writing.

I think a good compromise for both of you, would be for you to put your complaint in writing and for you to receive a written account of exactly what HAS been done to minimise the risk of this happening again. Many complaints can be resolved at this initial stage, it won't be a huge issue in terms of cost to the hospital, as the initial investigation has already been done and it will hopefully allow your DH, as well as you to put things behind you.

Other staff learn from high risk type meetings, change in protocols, etc. A complaint won't make any difference to whether or not its discussed with other staff. For one thing complaints are confidential, secondly if something is worth discussing with other staff it will be discussed without a complaint.

The only thing that happens with a complaint is that it goes to the complaints dept who forward it on to he relevent manager. Anyone involved has to spend hours writing a statement. The manager then writes a letter back to the person saying yes we're sorry that has happened, things will be changed. But you've already had that.

I don't really think as a member of the public/patient that there's anything you can do to influence that. The decision at the end of the day is the ward manager or Dr in charge. They decide if its something that needs discussing with everyone, or whether it was an individual's actions that were the problem (ie they should have known better and tehre is no reason to think anyone else would do this). I suppose when you talk to them you can just say that you hope all staff are being informed about the incident so it can be of use to everyone.

It does sound from the OP that they will be doing this, if they change proceedures then they have to inform staff of this.

The only complaint I've had made against me I hadn't done anything wrong. So there wasn't really anything to discuss. However another member of staff didn't follow protocol, no harm done, no complaint - but everyone knows and there have been numerous reminders on the board and emails about this situation. Noone would know about my complaint if I hadn't chosen to tell people.

I think that it would be the responsibility of the supervising clinician in an adverse incident to consider if there is a need for staff training, change to protocols etc. They would then either organise this or inform their senior depending on the issues and seniority of people involved.
This should obviously happen whether or not a formal complaint is received or not. I work in a hospital, and if anything adverse occurs then that is discussed, and investigated and and required changes implemented (usually any complaint would be received a long time after the incident was known about).

Thanks again - more helpful comments - especially good to hear from the two stripeys (!) who work in hospitals. I've talked to my DH, and I think we've clarified that there are two problems...

1. that we were sent home with the all clear, ie no guidance on when to come back and the impression that we shouldn't need to. It sounds like they are considering whether they should put more procedures in place for that and perhaps have a sheet of paper covering warning signs etc. I'm happy with that - any one could be on the right side of OK, but then deteriorate later.

1. this is the tricky one - the doctor we saw first who gave us the all clear, both me and my DH don't just think he made a wrong call, we think he was actually pretty incompetent. He said there was no wheeze, but DH could hear it from the other side of the room; he said to look for a dimple in the chest, and pointed said dimple out to DH but said it needed to be worse than that; he said he couldn't discharge DD until she's stopped crying so he could assess her better, but then he discharged her anyway even though she was still crying (and grunting as she couldn't breathe out properly), etc etc. However, its basically our word against his - if he's recorded there was no wheeze, we can't really prove otherwise. I assume that, from what stripey says, if this doctor needs more training etc, then this will be picked up internally, and a complaint won't make any difference either.

DH says that he asked the consultant he spoke to about these issues to put their conversation in writing, ie to confirm what steps they had taken. So I guess we wait and see what that letter says, and if we are happy with it, then no need to take it further. Thanks everyone, has really helped us to think about this...

I also work in a hospital as a doc (albeit nothing to do with children or chest problems) and fwiw I agree with everything stripeyknickersspottysocks has said.

To address a specific point I also think its entirely possible for you to think you can hear your dd wheezing but there to be no wheeze when listening with a stethoscope. I know this because a GP explained to me when my ds was poorly recently.

To clarify this - if they have an irritation to the upper airways (around the throat) their breathing can be very noisy and sound like they are wheezing. True wheeze (which is a problem caused by narrowing of the lower airways (lungs) such as in asthma) is defined as a noise you can hear through the stethoscope when they breathe out. If you listen to your child breathing without a stethoscope it is almost impossible to differentiate the 2.

I am not saying the doc was incometant by the way as couldn't tell based on this alone. Just that if you go down the formal complaint route and they hold the line that the doc couldn't hear wheeze that might be why.

I agree that you and your dh should do whatever you feel you need to to get past this and move on. To complain or not to complain - not sure it will make any difference how much is done about it in the hospital as stripey says. The important thing is that the 2 of you feel that your concerns have been respected and taken seriously (which it sounds as though they have) and that as a result you can move on and put it behind you.

Hope dd is back to full fitness soon.

Thanks alicet - also very helpful. I suppose the doctor may well have been acting within the correct guidelines then in some respects; just that, as a mum, I 'knew' she wasn't right, just had to wait a bit too long for the docs to agree with me!

DH has just said that he feels relaxed tonight for the first time since last weekend - helped in no small part by you guys helping us to think this through, so a big thank you to you all .

have to say too that as docs we are always taught to really listen and take on board the mums (or dads) instinct as you clearly know your own child and whether they are OK or not more than any other. this doesn't mean always doing as you ask (eg admit if all tests / etc indicate all is fine) but that you should perhaps take a closer look and ask for senior input if your assessment and parents assessment doens't match

In your situation the doc was clearly wrong given what happened later but unfortunately when you have to make an assessment you have to do so based on what you can see there and then. Having said that if I am discharging a patient i would ALWAYS advise to come back if anything changes to cause concern.

i would say that given that the hospital are saying a mistake has been made that there are things in your dds records that indicate the doc who saw her did either miss or misinterpret something. But impossible to say for sure without knowing more.

Glad your dh feels happier today - hope dd is ok too. I would again say that between you decide if you think it would help you to move on to put in a formal complaint and either do so or don't depending on this. Both approaches are in my miind reasonable. good luck whatever you decide...