Night Owl, I think the OP is suggesting that all the notes have been 'lost.' Forgive Allwood. Many people who come to this forum have had horrible experiences with the NHS. Our opinions are formed by our life experiences and yes, maybe, at times they cloud our judgement. Ultimately, we know that most nurses are caring and hardworking. However, I too, have seen the dark side of the NHS. I'm sorry to say I have seen nurses who have seemed uncaring to the point of callousness. There may be many reasons why - understaffing, low morale - but when your loved one seems to be suffering needlessly, there can be no excuses. I think the bitterness becomes ingrained because complainants are often stonewalled by the management. It is torturous. I would estimate that 80% of people give up to save their mental health. There also appears to be no accountability when failures have been identified - usually at the litigation stage years later. We need an independent complaints process.

Select the column C by clicking literally where it says C in the top column. You will see the whole of column C become highlighted. Right click in any of the highlighted cells and choose Format Cells... from the sub menu (or something similar - I have no idea what version of Excel you are using). A new window pops up entitled Format Cells. Choose Number from the list on the left. On the right change the number of Decimal places to 2. Click OK. All the numbers should change to two decimal places. There are a number of ways of achieving the same thing. This is just one.

=SUM((A1)/(B1)) then use the format option to round down the number to two decimal spaces.

Well if the hospital fail to provide answers, you really are only left with the option of litigation. I have lost count of the number of times I have heard of situations where hospital managers are quite prepared to extend the pain and suffering of patients and their families by failing to admit mistakes, apologise and compensate where appropriate. These cases can drag on for years and years and it is completely shameful on those involved, seemingly devoid of the basic principles of right and wrong and who act to protect their reputations and careers. Worse still, they seem never to be made accountable. If you do end up in court you should get some answers, as long as the right witnesses are called,the right questions are asked and presuming they are not stupid enough to perjure themselves. It is more likely that the hospital will try to settle out of court if it looks likely to get that far. They would consider bad publicity a far greater concern than a maimed patient. I would be inclined to carry the action through, although you may be so worn out physically and mentally by this time, you'll just be happy to see an end to the whole sorry episode. I'm sure that this is part of the hospital's strategy. Good luck. I think you have a very hard battle ahead.

Ask PALS for the form. It is your wife who should make the request (Subject Data Access request) and basically she is entitled to any document of which she is the subject. So it could be a letter from social services to the hospital consultant, but if your wife is the 'subject' of its contents, a copy of that document should be provided. There is a caveat in which data can be withheld if it is deemed to be damaging to the individual (I cannot remember the exact wording but it's something limp about may cause mental suffering blah, blah, blah). The other point is that you may not know that a crucial document is being withheld because you are unaware of its existence. However, you should get all the drug tests, nursing notes etc and you will know if these are missing. Applying for the data from so many different organisations may be costly. They can charge a maximum of £50 - or it was that one year ago. If you are going to make a formal complaint against the hospital (it may be the same for other organisations) you need to do this within six months of the incident. I think once your wife makes the request, there may well be a suspicion that you are intending to launch legal action and you could find that they 'circle the wagons.' So if you intend to have a face to face with anyone to innocently glean information, do it beforehand. Good luck. As I said before, I am extremely interested in the outcome.

Your ire at the lady who referred your wife to social services is justified, but also question the system that allowed her to unilaterally make such a decision. It also reeks of poor communication within the department and management failure. And, at the end of the day, it may be proved that the whole situation only arose because the symptoms of toxicity were not recognised. I suspect your enquries will hit a brick wall or everyone will blame everyone else and nothing much will change. Take my word for it, don't just accept their word that procedures have altered (standard practice to complainants), ask to see the document.

I would be very interested to hear the outcome of this. I remember being told by a consultant that I couldn't prove toxicity. I was almost tempted to get a hair sample tested. Yes, the notes should list the symptoms (although I often found big chunks missing because the nursing staff have so little time) but getting a medic to admit failure/lack of knowledge will be the hardest thing.

This is difficult. It sounds to me that the NHS was brilliant in many ways. Your story, however, rings so many bells for me. I am almost convinced by your description of your wife's symptoms - stupor, almost dementia like - were caused by the dosage of Epilim being increased too quickly, because the medical staff were acting upon results of the standard blood test. Your wife's and your own wishes not to increase the dosage were ignored. I can only suggest that you ask for the blood test results just to confirm that unbound levels were not checked and then make an appointment to see the neuro to discuss your concerns. You will not be able to prove now that your wife was suffering the side-effects from toxicity. What I find so frustrating about the medical profession - and I am sure that it exists in other professions too, but most of them are not life or death - is the unwillingness to listen to the patient and their families and an inability to acknowledge mistakes and learn from them. I don't know what your relationship with your neuro is like, but I do hope that something positive comes out of this and that policies and procedures with regards to patients with epilepsy change so that others do not suffer the same fate.

The OP says they have a solicitor - my worry is that they are paying for this and seemingly getting nowhere fast.

First of all have you or your solicitor made a formal complaint to the CEO of the hospital to ask if there was a clinical decision not to give anti-biotics to your son initially and what were the reasons for this? Notes or no notes, they should still be able to provide an explanation on what happened to your son unless it was years ago. I am a little confused over the verbal admission of negligence by the doctor. If it was a conversation which occurred in the presence of a nurse, are they both denying it? Have the notes from both hospitals been lost? All of them? Has your solicitor not been able to get any clarification on what happened? How did your son get scarring on his head and lips? Were you able to visit your son in the hospital he was air-lifted to and did any member of the medical profession advise you of what was wrong. Have you or your solicitor contacted the consultant that cared for him there? Is your solicitor charging you or is it a no win no fee?

If your wife was deliberately (and you'd have hoped that the doctors would have discussed this with the patient and family beforehand) over medicated then it will appear in her patient notes and the signs of toxicity should have been noted by the medics and the nursing staff should have been made aware also. Did the social worker have access to the notes? Did he/she speak to the (nursing) staff/consultants caring for your wife and was he/she made aware that the cognitive impairment was temporary and purposely done to protect mother and/or baby and an assessment at that time would be misleading to say the least. I think it worthwhile to apply for Subject Data Access from the time of your wife's admission and specifically ask for drugs charts, nursing notes, computerised drug test results. What happened when you raised your concerns about toxicity? When did your wife last see a neurologist specialising in epilepsy? New drugs maybe available. There could be new advice for those on certain drugs, especially for women of child bearing age. I know, for example, that phenytoin interferes with the metabolism of Vitamin D. Therefore it would be sensible to take a supplement to lessen the chances of osteoporosis later in life. A GP and non-specialist consultant are unlikely to know these kinds of things. It's up to you what you do if you find that the medics were mistakenly over-dosing your wife. However, you could have the opportunity to influence the hospital's policy on the way your wife and other patients with epilepsy are treated in future. It could also mean that social services alter their approach when assessing pregnant women with epilepsy. What I have learned is that it pays to be well-informed and not to hesitate to challenge a medic persistently if you feel they are wrong. We are all fallible, regardless of how many years we have studied, in whatever profession.

I do understand where you are coming from. I would be angry too. I am also keen for medics to be better informed about anti-epileptic drugs. Normal blood tests can often show a drugs levels to be below or normal, when infact they are not because of other factors. I know this to my detriment and relate to the cognitive impairment you mention as a sign of toxicity. I know also that medics who are not specialists in epilepsy fixate on the standard blood tests but are ignorant of the pharmacokinetics. Check that the blood tests were for the unbound levels of the drug. It should normally show up on the printout, but specifically ask if necessary. It may be important for the future and it may prevent another person being misdiagnosed or suffering.

I can only say that I know my local Acute Trust does not have the facility to test for unbound levels and that the consultant when pressed told me that there were very few locations the country that could carry this out - Guys was the one he suggested but they have a very slow turnaround and the NES - private and you pay - offer a 24 hour turnaround.

Sadly, I can say with some experience Night Owl that you are wrong. Sodium Valproate like Phenytoin binds to plasma protein and only a blood test that shows the unbound levels can be accurate. I know that my own local hospital do not have the facility to test this and the serum had to be sent to Guys/NES for testing. Also, often GPs are not getting discharge sheets from hospitals in a timely manner. The potential impact for the patient is scary.

Whilst I agree with the previous post, I have found that there is a general (and dangerous) ignorance of epilepsy and the drugs used to treat it within the general medical population. There is often one specialist covering several hospitals and the local consultant is either too proud to ask for help and/or has not the time or inclination to read the BNF or NICE guidelines. The situation is as it is. Social services will 'interfere' for however long they deem necessary. Still, I would be hopping mad and feel, rightly or wrongly, that an indelible stain had been placed on my character and ability as a parent. Was your wife's blood monitored carefully whilst the drug dosage was increased? I am familiar with the anti-epileptic phenytoin and know that the 'unbound' levels of the drug should be tested under certain circumstances, such as pregnancy, but also for people with certain illnesses and for certain demographics. This blood test has to be sent off - there are I think only a limited number of places in the country that carry this out; one is Guys in London and the National Epilepsy Centre has its own labs. The simple in-house test is not adequate. If this was not done, it would be somewhat worrying, especially as the signs of toxicity were so apparent. Get your wife to ask for her notes under a Subject Data Access - you only want the blood test results so it shouldn't cost much.

I'm praying you don't do a job where basic maths is a necessity - like nursing!

Yes, it seems to be extremely typical treatment for the elderly in our hospitals these days. I have to say, I think you are on a hiding to nothing if you think the hospital management will take notice of your complaint. They'll say all the right words, but the next patient through the doors is likely to suffer the same. Did you ask for a post mortem? Personally, I would not take the hospital's word for cause of death. I would also want to know whether the condition could have been treated - in fact if it would have been treated if the patient was say 20 years younger, in which case I would consider this a breach of Human Rights. Have you looked at the hospital's Patient Opinion website? Are other people saying the same thing (not that its heavily used, but you'll have some indication). If you want to pursue this you should request your relative's notes through a Subject Data Access - ask PALS for the form. You should then make a formal complaint to the hospital (but like I say they'll just fob you off like they do with everyone else). If you don't accept or are unhappy with the response, there is the Ombudsman. I may sound cynical, but I have grave doubts about this organisation's ability to champion the patient or their bereaved relatives or have any impact or influence when it comes to improvements in healthcare. Unhappy with all of these, ask your local paper to include your letter to their Letters page to find out whether others in your area have similar issues. Julie Bailey and her campaigners have, after years, managed to get a public inquiry for Mid-Staffs. On the flip side, the CEO of that hospital walked away with a million pound package and yet another hospital manager in Kent received around £300K in damages despite presiding over the worst c-diff outbreak in NHS history, which killed around 270 patients. So you see, life is extremely unfair, justice is the domain of the rich and the guilty normally escape scot-free, despite the efforts of so many to change things.

I'm sure you realise now that you should have asked a solicitor to check over the lease before signing, but we are all smart with hindsight. I'm wondering if you could go down the county court route to reclaim your deposit (and perhaps costs), producing your photographic evidence and witness. It would only require a small financial outlay and a bit of your time. I think the crooks of this world - like your landlords - know that most people are reluctant to launch legal action against injustice because of the cost and hassle and even then there are no guarantees that the law falls on the right side. However, this sounds as though it may be make or break for your business, so I'd have thought it worthwhile.

Well, I guess my advice (and it is just advice because at the end of the day you should always go with your gut feel, because it's rarely wrong) to keep it short and simple. [DATE] Dear Sir, I am writing to you concerning my tenancy of the premises at [address]. My tenancy commenced on ? and ran until 07/05/2010. As the deposit was paid after 6 April 2007, you the landlord are required by law (Housing Act 2004) to keep the money in a separate account, and to provide me, the tenant, with a written statement detailing (a) exactly what the deposit covers and (b) when the money will be returned. Please provide evidence that you have complied with this statutory duty. Once I have received this information I will engage the scheme's alternative resolution service to resolve our dispute over the deposit deductions. If you fail to reply within 14 days after the date of this letter, I will have no other option than to commence a County Court Action for recovery of my deposit. Yours faithfully Signature Send it Recorded Delivery. Now, I'm pretty sure that your LL will not have secured the deposit and will either not reply or try to intimidate you with threats. Stand your ground and follow the action through. Come back here for more help or call Shelter for free advice

Check out the stickies on TDS. You should contact (always write Recorded Delivery) to your LL first to ask which scheme the deposit is secured in with a note to say that if you do not hear back by a certain date (give her 10 days) you will apply to the court for recovery of your deposit x 3. Don't be daunted.

I think the PC I'm on is wind-up so won't download your file. The important factor here is what date the tenancy started. Did neither you or the LL/Agent date the agreement? Anyway if the agreement was taken out after 6 April 2007 your LL/Agent was required by law to secure your deposit and advise you that this had been done within 14 days of its receipt. If there is a dispute regarding damage or breach of the tenancy terms then the ADR (alternative dispute resolution) service which is allied to the deposit scheme will become involved, otherwise the tenant's deposit should be returned without delay. The onus of proof is on the landlord or agent. They will need to provide reliable evidence, usually in the form of an inventory, or a schedule of condition and photographs, to support their claim for deductions from the deposit. It is important that you do not let yourself be bullied. I'm guessing your LL has broken the law and if she does not want to face a large bill, she will need to return ALL of your deposit. If I was the tenant, I wouldn't even be offering deductions for cleaning etc.

I'm sure you are not a raving looney. I'm pretty terrified of dogs myself, so I can empathise with the fear aspect. It obviously would be better if your grandchild was fostered by those closest to her. Good luck. I hope it all works out.

What not just ask, you have nothing to lose. Forgive me for asking, but will the authorities allow you to foster if you are agoraphobic? Could your condition be deemed to have a negative impact on those that you care for? I'm not having a go at you, I am genuinely interested. It must be a terrible condition to live with.

The creation of that document probably kept 50 people employed in the OFT for a whole year! Well, here's how I read it. The guidance (and it is only guidance) to the LL is to ensure that the tenancy agreement is fair and clear. If a tenant signs a contract without challenging any aspect that is not clear or he considers unfair, I would consider that contract to be binding - for both parties. If the tenant then sub-lets without notifying the LL and the LL on discovery serves a notice for eviction, (and sub-letting is one of the breaches that Shelter defines as a reason for eviction), the tenant would have to go to court to challenge the decision. I think that the circumstances would have to be extremely unusual for the court to find in the tenant's favour in these circumstances.

As a LL I would challenge that any tenant who thought they could sub-let without permissionn as it states that it is not allowed in most standard contracts. However, if I found out, I would serve notice on them to quit immediately for breach of contract. I would not want a tenant in my property that I could not trust. However, that aside, I do not think it would be fair or legal to deduct monies from a deposit because of this. I would only deduct from a deposit where there was damage beyond wear and tear. This LL sounds somewhat unscrupulous and I would wonder whether they have fleeced tenants in the past.