NHS Grampian hospital may have missed signs of developing pockets of pus in patient's lungs

A health board has apologised after hospital was found to have missed signs of pockets of pus developing in a patient’s lungs.

The patient’s child complained to the Scottish Public Services Ombudsman (SPSO) about the care and treatment provided to their parent during two admissions to an NHS Grampian hospital.

Both admissions were due to concerns around their lungs, and on a third admission, the patient was diagnosed with empyema, which is pockets of pus, in their left lung.

In their complaint to the SPSO, the patient’s child stated empyema was missed on the first two admissions and that their parent had been “unreasonably” discharged.

The watchdog took independent advice from a consultant specialising in both respiratory and general medicine for its report.

While it was found that there was no evidence of empyema during the first two admissions, there were “missed signs” that the condition may have developed.

The report highlighted the presence of high C-reactive protein (CRP), which indicates inflammation in the body, in the first admission, and a recent history of pulmonary and pleural infection for the second.

It was found that the board should have carried out further investigations during the patient’s hospital admissions.

The ombudsman concluded that NHS Grampian did not take “reasonable steps” to establish whether there was an evolving infection or potential for empyema to develop and upheld this part of the complaint.

In regard to the patient being discharged, the report found that on both occasions the patient had been “clinically well enough” to be allowed home.

However, on the first admission, there had been a “failure to recognise” the significance of the patient’s raised CRP and also upheld this part of the complaint.

The SPSO asked the health board to apologise to the patient and their child and recommended that rising CRP should “prompt further assessment” due to the potential for empyema to develop.

An NHS Grampian spokesperson said: “We accept the recommendations of the SPSO in this case. We have formally apologised to [the patient and their child] and would take this opportunity to apologise again publicly.

“We did not meet their, or our own, expectations in this case.

“All recommendations made by the SPSO will be implemented as specified.”