"More awareness of diabetes required"

About: NHS Western Isles

(as a relative),

My wife was diagnosed with diabetes at the age of three, so virtually all her life. In 2010 / 2011 she developed an ulcer on the back of her calf and should have been referred to specialist care but this did not happen. In 2011/2012 she picked up athlete’s foot infection in both feet, although she was given medication for this she was not made aware of the danger the infection could pose if not properly treated and cared for. The infection developed into ulcers, the doctor came to see my wife at home as she was unable to walk and antibiotics were prescribed but he did not seem to be aware that my wife should have been referred for emergency treatment. The following day I called the doctor again as my wife was in severe pain. The doctor did not feel it was necessary to come and see my wife as he felt the antibiotics had not yet had a chance to take effect.

However, he did come on the Friday after I had complained to the Health Board. This time he was accompanied by a nurse. The doctor examined my wife and was more concerned about the pain associated with the arthritis diagnosed in 2008 for which she was on long term steroids. He prescribed medication which was later found to be inappropriate as it was not suitable for someone with a fungal infection. The doctor left after writing out this prescription

The nurse who had also come with the doctor suggested to the doctor my wife should be seen by a vascular consultant, however the doctor left after writing out a prescription. The nurse, who had stayed behind, called the local hospital and asked if it was possible for my wife to be given an appointment with the podiatrist, bearing in mind it was now 2: 00pm on Friday. An appointment was given for the following Tuesday, in the meantime another nurse came on Saturday to change my wife’s dressings. On Sunday my wife was calmer and in less pain.

This all changed, on Tuesday it was not possible to take my wife to the hospital because she was in so much pain. I called the doctor who came and took blood tests and then left.

The following Monday the doctor phoned to say my wife should be taken to hospital straight away as she was very sick. I took her to hospital in the car although I feel an emergency ambulance should have been sent for her. It turned out that my wife had renal failure and heart failure.

The hospital on the Isle of Lewis does not have a vascular surgeon, my wife was kept at this hospital for a week before being transferred to the mainland hospital in Inverness. Here she was in hospital for 8 months before a double amputation was performed, below the knees, due to gangrene. I now understand that diabetes is not described as severe but terminal when it reaches this stage.

My wife died in late 2014.

I have since obtained my wife’s medical records and am concerned that the notes do not reflect what actually happened. The doctor’s notes following his home call after the athlete’s foot infection stated that her foot was a bit red, cellulitis spreading infection. At this point alarm bells should have rung but my wife’s condition was left untreated.

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Response from Maggie Fraser, Communications Manager, NHS Western Isles

Dear hiker167

We are sorry to hear about your situation, in particular that your wife sadly passed away. Please accept our condolences for your sad loss.

Any patient experience which is felt to have fallen below the high standards I expect is of concern to me.

We investigate all such events comprehensively and openly. May I ask that, in order to do so, you contact Angela Grant, Complaints Officer, (angelagrant1@nhs.net or Health Board Offices, 37 South Beach, Stornoway Isle of Lewis, HS1 2BB) who can set that process in action without delay.

Once again, we would like to offer sincere condolences following the sad loss of your wife.

Kind regards

Gordon Jamieson

Chief Executive

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Update posted by hiker167 (a relative)

Hi, Western Isles Health Board responded to my complaint regarding my wife's diabetic foot ulcers by saying the GP practice did not want to comment further. The podiatry dept, after taking a phone call from a nurse informing them my wife's feet are a mess and pulses are barely palpable, was told she has an appointment on Tuesday 16th. This was on Friday 12th, almost 100hrs away. Scandalous. Regards, hiker167

Response from NHS Western Isles

Dear hiker167

Thank you very much for having the courage to engage with us at this very difficult time following such a devastating loss.

I apologise that the complaints process can take a long time to complete, this is due to the nature of your complaint having a number of areas which require investigations and we wish to ensure that these are comprehensive and are given our full attention. Any patient experience which falls below the high standards expected is of concern, and any learning from this investigation is shared within our organisation to ensure that we continue to improve our services.

A detailed and personal response to your complaint will be provided to you directly.

Once again I would like to thank you for continuing to engage with us and should you require additional information about your complaint, please contact Angela Grant, Complaints Officer, (angelagrant1@nhs.net or Health Board Offices, 37 South Beach, Stornoway Isle of Lewis, HS1 2BB). Should you require additional support please feel free to contact the Patient Advice and Support Service located in the Citizens Advice Bureau (41-43 Westview Terrace Stornoway 01851 706913)

Kind regards

Gordon Jamieson

Chief Executive

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