Staff at an NHS Ayrshire & Arran hospital discharged a seriously ill patient into the back of a taxi — still in their nightwear — when the patient was “not clinically fit” to leave.
Medics also “missed opportunities” to diagnose the tragic patient’s kidney failure.
The revelations are among a raft of failures identified following an investigation by the Scottish Public Services Ombudsman (SPSO).
Some of the failures identified include:
- Missed opportunities to diagnose the patient’s kidney failure and infection
- The patient’s family’s concerns had not been given “appropriate consideration” during the second admission
- Delays in the clinical consideration of the patient’s abnormal blood results and recognizing the “severity of their condition” and:
- A failure to move the patient’s personal belongings between wards.
Discharge arrangements had been “poorly managed” and other failings included the patient’s “lengthy wait” in the discharge lounge.
And the patient was discharged with the “wrong discharge letter and medication” which led to them being ‘extremely distressed’ and feeling ‘undignified,’ according to their family.
There had also been a “failure to communicate” their discharge arrangements to the family.
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The patient’s identity has been withheld and was referred only as ‘A’ while their family member, who raised the complaint, is only known as ‘C.’
And it is not known from which hospital in NHS Ayrshire & Arran the patient was treated, or discharged from.
An extract from the SPSO’s report said: “C complained about the treatment a family member (A) had received from the board.
“A was admitted to hospital three times over a short period with severe stomach and back pain.
“Following A’s third admission, they were diagnosed with kidney failure and discharged to receive palliative care. A died a short time later.
“C complained that the board had missed opportunities during A’s earlier admissions to identify their deteriorating kidney function. C said that an earlier diagnosis could have prolonged A’s life expectancy as treatment could have commenced sooner.”
The SPSO took independent clinical advice and determined there were “missed opportunities” to diagnose kidney failure and infection, and the family’s concerns had not been given “appropriate consideration.”
The report also stated: “We also found that A was not clinically fit to be discharged from hospital following their second admission and their discharge arrangements had been poorly managed. These failings included A’s lengthy wait in the discharge lounge, and A’s transportation in their nightwear via taxi.”
Joanne Edwards, Director of Acute Services at NHS Ayrshire & Arran said: “We sincerely apologize to the family of A that we did not meet the high standards of care we strive for.
“In addition to our formal apology to the family of A, I can advise that we have fully accepted all the recommendations in the Scottish Public Services Ombudsman (SPSO) report.”
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