Ambulance crews' failure to adequately assess a patient

An ambulance was called on 23 September 2024 for an elderly family member of mine. The patient was experiencing dyspnoea, severe heartburn and reflux. Patient is in end stage COPD and has a pacemaker. The ambulance arrived 49 minutes after the initial call. Upon arrival, vitals were taken and one ambulance crew member stated that as the vitals appeared normal, the patient should merely continue with her oral antibiotics. The heartburn was dismissed as something she had possibly eaten. When the patient insisted that her heartburn and reflux was severe, it was again dismissed by the second ambulance crew member stating that he also gets heartburn if he eats tomatoes. Both crew members were extremely reluctant to take the patient to casualty and stated that we could call them later again, if need be. I stated that we should rather go to casualty and if the docter on call felt it was not necessary for admission then we would accept his decision, but as a qualified nurse myself, I found it deeply concerning that, although vitals were within limits, the clinical presentation of the patient was ignored.

Upon arrival at casualty, the patient was admitted into high care for 3 weeks with Covid and a paralytic ileus. I filed a formal complaint with Netcare, citing that the ambulance crew had failed to adequately assess the clinical picture of the patient and had we not insisted on transportation, the outcome may have been far more dire. The response I got was that the ambulance crew had been sent on a communication course.

I find it most concerning that firstly the ambulance crew appear to be unable to adequately assess a patient and secondly that complaints are not properly resolved. How a communication course is going to prevent the crew missing vital clinical signs again in the future remains a mystery. My complaint was then forwarded to the Regional and Cluster Managers for my area and from there it appears to have fallen into a black hole.