Case summaries

These short, anonymised stories show the profound impact that failures in public services can have on the lives of individuals and their families.

Please note we have not published any new case summaries on this page since 2015. In April 2021 we began publishing our casework decision statements and investigation reports on our decisions portal.

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Emergency department failed to record prescribed medication

Summary 734 | January 2015

An emergency department did not record that it had prescribed a woman antisickness medication.

Trust failed to arrange follow–up appointment for child but realised this and provided suitable remedy

Summary 733 | January 2015

Miss V complained about the inadequate care and treatment of her son in connection with a potential operation to remove his adenoids. She said that the Trust failed to arrange a follow–up appointment for her son and she also complained about the way it had handled her complaint.

A surgeon did not tell a patient about what happened during an operation

Summary 732 | January 2015

During Mr T's colon operation, his surgeon accidentally nicked Mr T's spleen, causing bleeding. The surgeon did not tell Mr T about this, and two weeks later his spleen ruptured and he had to have an operation to remove it.

Trust did not tell woman about all her treatment options

Summary 731 | January 2015

Ms H had fibroids and a growth on an ovary. The Trust did not provide all the necessary investigations and information, which meant that an early opportunity for treatment was lost.

Ambulance Trust correctly assessed initial 999 call, but there were shortcomings in second call

Summary 730 | January 2015

When Mr N's housemate called 999 on his behalf, he was referred for a clinical telephone assessment instead of an ambulance being immediately sent. Mr N was not retriaged during the second 999 call.

Trust could have offered better support after eye surgery

Summary 729 | January 2015

Miss V had cataract surgery. She complained about later eye problems that she felt were caused by the surgery.

GP Practice unfairly removed entire family from its list

Summary 728 | January 2015

Miss G complained that she and her daughter had been removed from the GP Practice's patient list because of missed appointments. Her partner Mr W complained that although he had not missed any appointments, he too was removed.

Trust did not remedy failings found in maternity care

Summary 727 | January 2015

Mrs C complained about the pre and post–natal care she received at the Trust, including delay in finding her a bed after she had given birth. Mrs C said that the failings she experienced contributed to her being unable to establish breast feeding. She also said she had suffered anxiety. She sought a refund of her costs and compensation for distress caused.

GP Practice's failure to repeat blood tests resulted in delayed diagnosis of a thyroid condition

Summary 726 | January 2015

Mr and Mrs R complained that the GP Practice missed opportunities to diagnose and treat Mrs R's low thyroid condition.

Trust failed to identify signs of infection in blood test

Summary 725 | January 2015

Mrs U complained that her mother, Mrs T, was not given adequate treatment when she was admitted to hospital with an infection and she was discharged despite having had a blood test that showed infection.