Report Date


Case Against

Betsi Cadwaladr University Health Board


Clinical treatment in hospital

Case Reference Number



Upheld in whole or in part

Mrs C complained that she was not given adequate sedation when undergoing a colonoscopy at Glan Clwyd Hospital.
We found that Mrs C was given appropriate sedation and pain relief when undergoing the procedure. However, she should also have been offered gas and air (a mixture of nitrous oxide and oxygen used to relieve pain and anxiety). We found, on the balance of probabilities, that this was not offered, which was service failure. We considered that if it had been offered, it was likely to have relieved her pain and anxiety to some extent, although it would probably not have controlled her pain completely. The failure to offer gas and air was an injustice to Mrs C, and to that extent we upheld the complaint.
The Ombudsman recommended that the Health Board should apologise to Mrs C for its failings and provide evidence of an audit of the checklist pro forma being completed before carrying out colonoscopies.