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Clinicians failed to discuss epidural risks with patient

Raigmore Hospital
Raigmore Hospital

NHS Highland has been told to apologise to a patient after doctors failed to discuss the full risks of an epidural with her.

“Mrs C” was admitted to Raigmore Hospital in Inverness after suffering two days of stomach pain and vomiting.

She was found to have a small bowel obstruction for which she needed major surgery. The operation was carried out the next day and the patient was given an epidural (anaesthetic by spinal injection) and a general anaesthetic.

Mrs C then noted reduced mobility in her legs and a scan was carried out, but this showed no abnormality. Her mobility did not improve and she was seen by a neurologist and a repeat scan was performed but, again, was normal.

It was explained to Mrs C that the likely cause of her lack of nerve sensation was a spinal stroke, where there is an interruption in blood flow to the spinal cord.

Later, Mrs C complained to the health board because she believed that she should not have been given an epidural and a general anaesthetic together because she had a history of heart problems.

She brought her complaint to the Scottish Public Services Ombudsman (SPSO).

The SPSO took independent advice from a consultant anaesthetist and a stroke specialist.

It found that it was common practice for an epidural to be used in conjunction with a general anaesthetic for post-operative pain relief after major abdominal surgery and there was nothing in Mrs C’s medical history that would have discouraged clinicians from doing this.

A spokesman for the SPSO said: “For this reason, we did not uphold the complaint. However, we also found that prior to the operation the full risks of an epidural, including the risk of nerve damage, were not discussed with Mrs C as we would have expected.”

The body asked the health board to apologise to Mrs C for not fully discussing the risks of an epidural and recommended that it do this with future patients.

An NHS Highland spokesman said: “We have apologised to the patient for the failings in care. We accept the findings of the report and steps have been taken to ensure we are meeting the recommendations. These include updating the anaesthetic checklist and patient information forms.”