March 2016

Date: 01 March 2016

  • Details:

    The complainant called the local Health Care Centre as his father was in so much pain he could not walk. They did not send a doctor but the nurse came that evening. The Doctor attended the next day and prescribed antibiotics.

    As the patient was still in pain, the complainant called NHS 111 the following day who in-turn dispatched an ambulance. A Paramedic arrived and did splendid job medically but he had a terrible bedside manner - he told the complainant that it was his job to get his father to the hospital, not the ambulance crews. Upon asking about the his father’s antibiotics, the complainant was rudely advised "Well they are no good in the packet". The paramedic did not want to send the patient to hospital claiming they would be "too busy", "there would not be much point" and he "didn't see what good it would do as he would just be sent back home". He asked the patient three times if he “really needed to go to hospital?”, after which the patient was not conveyed to hospital.

    As the patient was still in excruciating pain later the same day another ambulance was requested who did convey the patient Hospital; the patient was admitted to the Intensive Care Unit due to having septic arthritis. The complainant feels that the original paramedic had no right to "play God" and should treat patient's as people and not numbers, he was very upset that his father was not dealt with as best as he could have been and feels he could have been saved a lot of pain if he was taken to hospital as an emergency. The patient sadly passed away several days later.

  • Findings:

    The investigating manager spoke with the complainant about the concerns raised. The staff member was interviewed and also reviewed the documentation that was completed at the time, whereby the Paramedic confirmed that he lacked knowledge on the subject of septic arthritis. The investigating manager explained that this is not covered on the paramedic syllabus, however, with the move towards providing more Urgent Care within the community it is likely to be covered in future. The Paramedic also stated that his decision not to convey the patient to Hospital was swayed by the Doctor’s previous visits, to which the Investigating Officer confirmed for the need to assess each patient fully and without any pre-conceived ideas.

    The Investigating Officer, having reviewed the Patient Care Record (PCR), found that it could be assumed that the patient had been suffering with an infection and felt that Paramedic’s decision whether to provide urgent transport or not was suitable; however, it should have been arranged for an earlier time. She agreed with the complainant that the decision to provide transport does not come easily to ambulance staff and Paramedics are told to avoid admission where appropriate, but this needs to be referred on to another Healthcare Professional and needs to be appropriate.

  • Lesson learnt / action taken:

    The paramedic was requested to complete self-study on Septic Arthritis, training has been facilitated for the paramedic to enable him to have a greater awareness about the decisions he makes and methods of communication he uses, as well as the impact that this has on the patient and their family.

  • Date:
    01 March 2016