Pregnant woman wrongly told she had suffered miscarriage
Ultrasound scans were conducted too early for correct diagnosis, SPSO finds.
A woman was incorrectly told she had suffered a miscarriage and did not get appropriate treatment, it has been ruled.
Forth Valley Royal Hospital was found to have made errors over initial ultrasound scans, which were conducted too early for miscarriage to have been correctly diagnosed.
The woman, referred to as Miss C, had aspects of her complaints against the NHS upheld by the Scottish Public Services Ombudsman (SPSO).
In its decision the SPSO said: "In the circumstances, we considered that the board had failed to provide Miss C with appropriate care and treatment and we upheld this aspect of the complaint.
"The advice we received and accepted from the consultant in reproductive medicine and surgery was that it had been too early to diagnose a miscarriage and that there was no evidence consultant advice had been obtained.
"The adviser also said that there was a failure to record and obtain a complete menstrual history at the time of the scans.
"The advice we received from the midwife was that carrying out an ultrasound scan before six weeks' gestation would not normally happen.
"The midwifery adviser also said that it happened in this case in an attempt to meet Miss C's needs, given that she had recently undergone surgery.
"The adviser said that this was not clinically appropriate."
A complaint there was a delay in the decision to perform a caesarean section was not upheld but the ombudsman was "concerned about a number of communication failings and a failure in record-keeping".
In its recommendations, the ombudsman said the NHS board should remind staff of the need to record and obtain a complete menstrual history at the time of ultrasound scans.
The SPSO also said the investigation's findings should be brought to the attention of relevant staff, in particular the need for experienced medical involvement in a similar situation and the need for further scans.
In addition, the board has been asked to consider the advice from a midwifery adviser that additional training in relation to dealing with bereavement surrounding early pregnancies should be provided for midwives who regularly work in this area and remind staff of the need to maintain full and accurate nursing records in line with Nursing and Midwifery Council guidance.
NHS Forth Valley Board has apologised for the errors and said action has been taken.