Considering making a complaint after my rollercoaster ride so far!

[mumofethan]

Yesterday I had my anomaly scan which was fine other than the fact that all the results were measuring very small (5th centile for head and abdominal circumference and less than 5th for femur). I have a couple of blood clotting conditions so I was already completely panicking that the placenta had packed up at this early stage. When I got home last night I had another look through my notes. At my 12 week scan I was dated at 13+0 with a CRL (crown rump length) of 66.5mm. However at the time we were suspicious as we were watching the whole time and only ever saw measurements in the 50s. Then I saw on one of my scan photos a measurement of 55.3mm! To top it off my scan report said I had a posterior placenta but my scan yesterday and my Amnio both said anterior! It can't change! I saw the consultant today who reviewed all the scan pictures on the system and found that my maximum measurement was 55.3mm putting me at 12+1 when my scan was done, and that my measurements yesterday were actually within normal ranges.

At my nuchal scan she couldn't get the measurements she needed because of the awkward lie of the baby so I had a quadruple test which uses the CRL (which we know to be incorrect now) and got a 1:70 for down's, hence the Amnio (which came back clear). I just feel like I have been through all this unnecessary stress because the sonographer got it so wrong. Also, because of my blood clotting the placenta did stop working with my last pregnancy and I was induced early. The baby was on the average line to begin with though so I had a bit of leeway. If I hadn't noticed the scan was wrong then this whole pregnancy we'd have thought the baby started off too small so any drop off in growth would have panicked everyone into inducing me early. I actually get quite scared thinking about the what ifs really.

My consultant was great and has reported it as an incident but I'm not sure what will come of that, does anyone know? I am wondering if it's worth making a complaint or if the fact that my consultant has complained on my behalf is enough?

Thanks if you have read this far and thanks in advance if you have any advice!

That sounds rubbish! Is the name on top of the scan correct??

If incident reporting works the same everywhere, the 'clinical incident' forms all end up in an office where the governance team review them all and looks at how bad the incident was (level of harm/potential for harm), and how likely it is to recur. With that they examine the processes involved and look to see if it needs altering. Action depends on the previous scores (big incident, likely to happen again = ton of bricks moment; once in a million minor event = poster on the coffee room door...) Lots of incident forms are filled in every day, but not many by consultants, so they are taken seriously.

Having said that, if it were me, I'd make a seperate complaint (google your hospital's PALS team). Even if one sonographer just need reminding how to measure properly, they will likely give everyone a refresher, such is the no blame culture in the nhs at present.

Hope your little one keeps on growing :)

Hi One, thanks for replying! Yes the name on the report was right which is why I didn't question it at the time. Thanks for the info about clinical reporting; I am not sure how bad they will rate this though? To be honest I am kind of glad I had the Amnio even if I didst need it but that's because it turned out ok (as in I didn't misscarry).

I spoke to a friend yesterday who had the same sonographer in her pregnancy who told her that it was likely that the umbilical cord hadn't attached but that she couldn't see for sure and that if it hadn't there was nothing they could do. When she went back for a re scan the different sonographer apologised as it was a load of rubbish and she ought to have been able to tell. It makes me want to complain even more really but am worried about the care I will get for the rest of my pregnancy. I will need further scans (at least 4) and I am now scared for her to do it. Can I refuse her?

Thanks again for your advice, I am glad now especially glad it was my consultant reporting it!

Trouble is although it sounds like this sonographer needs retraining, nobody can be certain that with another sonographer you would have got the nuchal and then that would have been favourable and so no amnio. Difficulties with baby positioning are a known scan problem and there is only so much the sonographer can do. I don't think we can definately say therefore that the sonographers lack of competence resulted in your amnio.

The measuring error is another matter. You should expect this will be highlighted with the department and staff concerned and that they implement any additional training they feel is necssary. If you contact PALS they should be able to feedback to you about that.

Northernlurker, I completely appreciate that but my quad test was now technically now done at 14+5 (too early?) and my Amnio at 15+2 increasing my chance of miscarriage. And to know that the quad test might have been fine if the right length was used makes me feel a bit sick! But I know it could have still turned out this way. no way of knowing now though!

Not sure how much harm they would ascribe to the error - you have undergone a procedure not without risk on the basis of results that were both indirectly related to the same person's measurements. If you imagine a blood test coming back (e.g. tumour markers) and then undergoing surgery based on it... it's not a million miles away.

As for complaining, it certainly shouldn't affect your care through the pregnancy - it should all be dealt with fairly anonymously. You are well within your rights to ask for a different sonographer. Does your hospital have a foetal medicine unit? I get scanned by the consultant there (I work at the hospital and they know I'm high risk, but I don't want the whole department knowing why!).

At least the amnio was fine :)