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Letter Of Complaint

kim & Tilly

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On Sunday 30th July at 4pm, my son * 8yrs, was bitten on his face by a dog, while he was at a banger racing event with his dad. St Johns ambulance patched him up and sent him to Weston-super-Mare General Hospital; they had a look, cleaned the wound and covered it with a dressing. Unfortunately they were unable to transfer * to * Hospital that night as there weren’t any beds available, so he was sent home with an appointment for 9am Monday morning to go to the * ward.

We arrive Monday 31st July at 9am as instructed, * spent some time on the ward before he was assessed by the surgeon, Mr *, who was doing the operation, he explained what he was going to do with the wound and how he would close it up etc. I signed all the necessary forms and * was given a wrist band (number !!!!!!), he was taken down for the operation at 4pm, by 5.30pm he was back the operation had gone well and he was fine. * stayed overnight in the * room, he continued to be assessed and given medication.

The following day, Tuesday 1st August, * spent the day on the ward, and at about 2.30pm we were visited by the surgeon, Mr *, who had performed the operation, he had a look at the wound and asked a nurse who was with us to make some appointments for * to come back. The first appointment was for 10.30am Thursday 3rd August to see a nurse and to make sure the wound hadn’t become infected; the second appointment was for 1.45pm Tuesday 8th August for the surgeon Mr * to assess whether some or all of the stitches should be removed.

We attend the first appointment and spoke with a nurse who said that *'s notes had gone missing. She had a look at his wound and said it looked quite good, she gave us some advice about what to put on it, keeping it out of the sun and making sure once the stitches where out that we massaged the area to stop it going lumpy. She asked when our appointment was to come back and have the stitches out and we told her it was the following Tuesday. She didn’t seem too happy with this and said that most stitches come out earlier; so she made an appointment for * to come back at 10am Saturday 5th August to have the stitches removed.

We arrive for our appointment at 10am and had to wait a short while, as we were waiting on the ward for a nurse to become available, she removed *’s stitches and put them in a pot for him to keep. We got home at 11.30am and had some lunch, at 12noon * sat down to watch some television, I was in the kitchen when my husband called me, * had yawned and the wound had fully opened up and was bleeding. I quickly covered the wound with some dressing I had in our first aid box using some plasters to secure it and we drove back to hospital. We arrived at the * ward at about 12.30pm and were taken into the treatment room, I was very upset and waited outside the room as I was crying and didn’t want * to get upset. They had a quick look and said they would page the Doctor to come and have a look. At about 5pm the Doctor and a nurse came to see * and I had to sign all the necessary forms again and * was given a wrist band (number !!!!!!) as he had had lunch he was unable to have the operation until after 6pm. I asked if * had a bed and we were shown into the * room (bed 1), * settled down and watched the television.

At about 9pm the surgeon (a different one) came to see * and said he was unable to do the operation as two emergencies had come in and wouldn’t finish until the early hours of the morning; He said that * could have something to eat and drink. When he had gone I asked the nurse if she could change *’s dressing as I had put it on when we were rushing back and it had started to fall off, she went of to find out, but came back a while later saying they had decided to keep it on. I was unhappy with this as the first surgeon had made a fuss about making sure it was kept very clean as it was a dog bite and likely to become infected. After I made a fuss they did change the dressing.

In the morning * was prepped ready for surgery, and was taken down at 11am, he was brought back at 12.45pm and again the operation had gone ok. The nurse made an appointment for him to come back and have his stitches removed at 9am Monday 14th August, he was then allowed home at around 6pm.

As you can imagine this has been a very traumatic time for *, he was extremely worried about being put to sleep the first time, as he was worried he wouldn’t wake up, he kept asking if he would be put to sleep when the stitches came out and we assured him he wouldn’t. We feel that because of nurses’ negligence he was unnecessarily put through surgery a second time and maybe scarred far worse, than he would have been. The nurse made a decision without consulting *’s notes (as they were missing) or talking to the Surgeon who had performed the operation. The injury * suffered was a very deep incision to his cheek; the dog had bitten a chunk out of his cheek, very close to his mouth, this needed internal stitches as well as external.

I am sure the surgeon, Mr *, made the appointment for 8 days later, as he felt it was necessary to allow the wound to heal fully, and when he had looked at it he would have made the decision whether to remove some or all of the stitches. The nurse who saw us based her decision on what she saw, and as such the stitches were removed after just over 4 days, and I am certain that this decision contributed to the opening up of the wound and *’s need for a second operation.

* is now terrified of having the stitches out as he is worried that the wound will open up again, his dad and I are worried about the possible 'worse scaring' that may occur and the physiological effect this has had on *.

I look forward to hearing from you within 7 days of receipt of this letter

Can you read and tell me if you think it sounds ok.....i need a better ending, and im not sure i should call it an incision, as it was a bite out of his cheek..
 
Good for you complaining Kim. :luck:

My OH is a nurse and he says they often take stitches out after 4 or 5 days, obviously depending on how the wound has healed.

Poor Sam I hope he is feeling OK.

Someone may be able to give you some advice on the actual letter - it seems very long but I dont know if you could leave any of it out as it's all relevant.
 
hey hunny

the letter seems very well put out, the only thing i would change is at the end where you put

I look forward to hearing from you within 7 days of receipt of this letter

i would put somthing more like

i look forward to your prompt response

 

regards mrs ******

it just sounds a little more professional, hope this helps

em
 
It sounds fine Kim, I think it is good that you have detailed the emotions as well as the facts. I am in a similar situation to you at the moment with regard to my old dental practice. It's tough and they will wriggle, but keep up the pressure :thumbsup:
 
I think that the letter is fantastic- so clear and detailed. I have sent you a PM with a few minor grammatical changes that might make it run a bit more smoothly.

GOOD LUCK :luck: :luck:
 
Rae said:
Good for you complaining Kim. :luck:
My OH is a nurse and he says they often take stitches out after 4 or 5 days, obviously depending on how the wound has healed.

Poor Sam I hope he is feeling OK.

Someone may be able to give you some advice on the actual letter - it seems very long but I dont know if you could leave any of it out as it's all relevant.

Not for a wound that deep that required surgery and internal stitching. AT LEAST 7 days.

Absolutely for more superficial wounds 4 days would be enough. Have you had a look at the initial photos of this injury? NO WAY should stitches from that wound have been taken out at less than a full week, and potentially could have stayed in longer if the surgeon wasn't happy.

Kim & Tilly the letter sounds great, but you haven't stated what you are wanting them to do at the end of it. You're just asking to hear back... I dont' know if you'd want to make it any clearer or leave it as it is and see what their initial response is. Overall it's very good - very clear and giving the facts without being over emotional (while still explaining how you are all feeling), so you've done a GREAT job with it.

Wendy
 
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chelynnah said:
Rae said:
Good for you complaining Kim. :luck:
My OH is a nurse and he says they often take stitches out after 4 or 5 days, obviously depending on how the wound has healed.

Poor Sam I hope he is feeling OK.

Someone may be able to give you some advice on the actual letter - it seems very long but I dont know if you could leave any of it out as it's all relevant.

Not for a wound that deep that required surgery and internal stitching. AT LEAST 7 days.

 

Absolutely for more superficial wounds 4 days would be enough. Have you had a look at the initial photos of this injury? NO WAY should stitches from that wound have been taken out at less than a full week, and potentially could have stayed in longer if the surgeon wasn't happy.


No my OH hasnt seen the pictures, and I wasnt suggesting that they should have been taken out as obviously the wound was not closed, the point I was trying to make was that SOME stitches may be taken out after 4 days, incase Kim was under the impression that ALL stitches had to stay in for atleast 7.
 
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Before it was sent i added this bit

'we wish to discuss this further as we feel the nurse acted negligently with regards to Sam's care.'

Sometimes it just flows and this one did...i did think most stitches stayed in for at least 7 days, but understand they want to get them out asap, due to the stitches scaring, but if you look at the pics of the injury you will see it is very deep and would have needed a lot longer to heal, which is probably why the surgeon said 8 days.....bl**dy nurse
 
Kim and Tilly said:
Before it was sent i added this bit
'we wish to discuss this further as we feel the nurse acted negligently with regards to Sam's care.'

Sometimes it just flows and this one did...i did think most stitches stayed in for at least 7 days, but understand they want to get them out asap, due to the stitches scaring, but if you look at the pics of the injury you will see it is very deep and would have needed a lot longer to heal, which is probably why the surgeon said 8 days.....bl**dy nurse

That's good. That gives them an idea of specifically what you're looking for without coming across rude and nasty and getting their defences up too badly. Hopefully it will open the door for a good discussion and they'll be willing to come to some sort of reasonable agreement. Fingers crossed.

I think you did a great job...

Wendy
 
Good on you Kim for complaining and rightly so :thumbsup: .... I hope you get a response asap and a good one at that. :luck: :luck: :thumbsup: for SAM's sake.
 
Why don't you just contact the hospital Patient Advisory Liason Service (PALS) They can arrange a meeting for yourselves, the Consultant and the Departmental manager together where you can address your complaint directly.

I would refrain from commenting on when is appropiate for suture removal due to not knowing the full circumstances regarding the wound, and also what muscle / soft tissue damage is there. Along with the type of wound, choice of suture, it's possible need for drainage (there are small salivary glands in that region) and also the possibility that this was a primary closure and future wound management was planned and even scar revision. There is also the possibility the initial sutures where pulling the tissues as swelling was resolving which would possibly result in an unbalanced lip line. I work in maxillo-facial injuries and it simply isn't cut and dry as to when and how a wound is managed (yes I've seen Sam's pictures :( ). The person who should be able to provide you with a full explanation is the consultant managing his care, if the nurse has breached his treatment plan then they will need to give justification of their actions.
 
wild whippies said:
Why don't you just contact the hospital Patient Advisory Liason Service (PALS) They can arrange a meeting for yourselves, the Consultant and the Departmental manager together where you can address your complaint directly.
I would refrain from commenting on when is appropiate for suture removal due to not knowing the full circumstances regarding the wound, and also what muscle / soft tissue damage is there. Along with the type of wound, choice of suture, it's possible need for drainage (there are small salivary glands in that region) and also the possibility that this was a primary closure and future wound management was planned and even scar revision. There is also the possibility the initial sutures where pulling the tissues as swelling was resolving which would possibly result in an unbalanced lip line. I work in maxillo-facial injuries and it simply isn't cut and dry as to when and how a wound is managed (yes I've seen Sam's pictures :( ). The person who should be able to provide you with a full explanation is the consultant managing his care, if the nurse has breached his treatment plan then they will need to give justification of their actions.


at the mo i am just following their complaints procedure...

In red i think this is what she has done without looking at his notes or speaking with the surgeon, she made a desision based on what she saw not what she knew, and as a result Sam ended up back in hospital
 
You should get a quick response and probably a request to attend a meeting with the staff concerned and the PALS. I should also add that PALS are there to represent you rather than feeling it's you versus them IYSWIM.

Most responsible staff look at complaints as a means of fault finding where they've gone wrong and what they can do to ensure it doesn't happen again, even if his treatment to date was correct, they will still be concerned about possible break downs in communication and the distress this has caused. (I'm saying this incase your concerned that your complaint is taken in a negative manner)

Good luck :luck:
 
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wild whippies said:
You should get a quick response and probably a request to attend a meeting with the staff concerned and the PALS. I should also add that PALS are there to represent you rather than feeling it's you versus them IYSWIM. Most responsible staff look at complaints as a means of fault finding where they've gone wrong and what they can do to ensure it doesn't happen again, even if his treatment to date was correct, they will still be concerned about possible break downs in communication and the distress this has caused. (I'm saying this incase your concerned that your complaint is taken in a negative manner)

Good luck :luck:


Do they also deal with things like compansation or will we need to get a solicitor?
 
No and to be honest, without knowing if there actually is liability, I personally wouldn't see what this prospect at the moment holds.

I note you mentioned your was persuing compensation in regards to his actual injuries and I presume you have made contact with both the police and the Criminal Injuries Compensation board?

If of course his wound healed unfavourably directly due to his medical treatment received or he had been of detriment from it, then you would have a case for compensation claim but as scar healing is a long process I would forsee this as something that only time will reveal. If this is the case then it would be in your best interests to seek legal representation from an experienced medical negligence solicitor.

Info regarding PALS
 
wild whippies said:
No and to be honest, without knowing if there actually is liability, I personally wouldn't see what this prospect at the moment holds. I note you mentioned your was persuing compensation in regards to his actual injuries and I presume you have made contact  with both the police and the Criminal Injuries Compensation board?

If of course his wound healed unfavourably directly due to his medical treatment received or he had been of detriment from it, then you would have a case for compensation claim but as scar healing is a long process I would forsee this as something that only time will reveal. If this is the case then it would be in your best interests to seek legal representation from an experienced medical negligence solicitor.

Info regarding PALS

What about the fact he had to have two general anaesthetics due to the nurse going against what the surgeon had requested??
 
It's like I've said previously it's a matter of whether a) the nurse has done something against the treatment plan and b) whether her actions for doing so where justified. I'm not sure but I am only allowed to carry out suture removal upon instruction from a clinician after they have carried out an examination at that visit. However it may be documented in Sam's records for suture removal or the nurse themselves may hold additional qualifications where they have their own nurse - led clinics whereby they can assess and treat appropiately.

Of course there's a genuine risk with a general anaesthetic and the fact he has had to endure two is most unfortunate but maybe no-one thought that the wound would break down if tension was exerted (yawning)

There really is so many possibilites as to why circumstances came about but the only person who can give you the answers is the consultant. Personally, I think the sooner you can meet the better as this must be adding anxiety to both you and Sam. :(
 

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