Patient left alone fainted and injured herself

What happened

Ms F went to the occupational health department at the hospital for a vaccination. After the vaccination she felt lightheaded and the nurse advised her to sit with her head between her knees. The nurse left the room to fetch her a glass of water, and while she was out of the room Ms F fainted and fell to the floor. An occupational health doctor examined her and advised her that she did not need immediate medical treatment, but should go to her GP if she felt worse.

Ms F later went to A&E and was diagnosed with a broken nose and concussion. She needed two operations to reconstruct her nose. Ms F complained about the treatment she received and how the Trust handled her complaint.

What we found

We did not uphold this case. The nurse acted appropriately in advising Ms F to sit with her head between her knees. However, the nurse should not have left Ms F alone and should have asked a colleague for help if she needed a glass of water. We found that the doctor carried out an appropriate examination and gave appropriate advice about head injuries to Ms F. Ms F did not have symptoms to indicate she needed immediate hospital treatment and therefore it was reasonable that she was not referred to hospital.

We could not link the nurse's actions with Ms F's broken nose, as even if the nurse was present it is still likely that Ms F would have fainted and fallen to the ground. The nurse would not necessarily have been able to prevent Ms F's injuries. The hospital had already apologised to Ms F and acknowledged its failings. Even though the Trust did not diagnose Ms F's broken nose at the time of the fall, and this was only diagnosed when she went to A&E, this was not a failing because the diagnosis is usually made a few days after the swelling has eased and when doctors can do an accurate examination. Immediate X–rays are not usually helpful in the diagnosis of a broken nose.