GIRL C Addresss Addresss London Postcode Chief Executive Officer Princess Alexandra Hospital Hamstel Road Harlow, Essex, CM20 1QX United Kingdom Re: Formal Complaint Regarding A&E Dept. at Princess Alexandra Hospital D.O.B: XXXXXXXX NHS No. XXXXXXXXX Mobile: 00000000000 Dear Sir/Madam, My name is GI R G IRL C L C I am a young black transgender woman who sought urgent medical assistance after being rushed from an aircraft that had just landed at the airport following life threatening in flight complications from gender affirming surgery which I had undergone abroad. I am writing to you today to file a formal complaint regarding the appalling treatment I received at the Accident and Emergency (A&E) department of Princess Alexandra Hospital on the 30/09/2023. During my visit to the A&E department, I experienced egregiou s mistreatment and abuse at the hands of department staff, which was both traumatic and distressing. My account of the events is detailed below, and I request a thorough investigation into these allegations. 1. Ground s of Complaint My complaint is made out on the following five grounds, detailed under each header of complaint below. 1.1. Clinical Negligence - Failure to Provide Adequate Care and Pain Management: I experienced severe inadequacy in pain management, enduring prolonged suffering without receiving adequate medical attention. After being admitted to the unit, my pain was clumsily managed and, though pain relief was provided, it was poorly managed and coordinated. 1.2. One doctor (Consultant A) prescribed Entonox and then, according to one Nurse, (Nurse B) did not properly follow up this request leading to experiencing a wait of over an hour before the Entonox was administered. During this time, I was wailing uncontrollably in pain, verbally crying out for help. At one stage, Nurse B came into the cubicle and I asked for the pain relief prescribed by the doctor (Entonox). Nurse B claimed that nothing was on the system and so I asked if she could enquire with the doctor who had prescribed it, Nurse B then adopted an unnecessarily curt, rude and uncompassionate tone, proclaiming that she was very busy and had 15 other patients, she did not know who my doctor was and ranted that it was not her job to know who every one’s doctor was. I was crying and keeled over in pain. I eventually received the Entonox after approximately an hour of what I would consider unnecessary and prolonged pain and suffering. I was given other pain medications during my time in the department however these were not successful in managing my pain and this is why Consultant A added the Entonox to my pain management plan. Later, the doctor who had prescribed the Entonox insisted that he had in fact prescribed the Entonox, at the time he claimed t his, I could see Nurse B in the department, I called her over and she insisted, in front of Consultant A that there was nothing uploaded onto the system. 1.3. Clinical Negligence, Neglect - Disregard for Basic Needs and Dignity: I was left in distress, ignored when I sought help, and was forced to soil myself due to the unavailability of timely access to facilities and assistance. 1.3.1. I was left on the ambulance outside of the hospital for an extended period where my pain was unable to be sufficiently managed by the ambulance crew. Following this, I was wheeled in to be seen by the Triage Nurse (Triage Nurse L) who was callous, rude, refused to listen – continually speaking over me as I tried to explain my situation. Triage Nurse L attempted to refuse to allow my companion to accompany me despite her presence being requested by myself, citing that it was hospital policy – I asserted that it was my right to be accompanied and have someone to advocate for me and then Triage Nurse L said well you can talk for yourself. I persisted and Triage Nurse L eventually capitulated. 1.3.2. During the Triage, Triage Nurse L instructed an Auxiliary Nurse (Auxiliary Nurse M) to draw blood and he proceeded to do so. Triage Nurse L failed to notice that I had already been canulated in the ambulance and instructed the nurse to canulate me again. I noticed that the needle used by Auxiliary Nurse M was very large, far too big for my body and slight frame. The first attempt at canulation with the extremely large needle was unsuccessful and the source of great pain resulting in physical trauma to the s ite, I wondered if Auxiliary Nurse M had inflicted greater pain intentionally as punishment for challenging Triage Nurse L and being difficult. Auxiliary Nurse M then proclaimed, “Ok, im going to need a smaller needle, I’ll be right back” and this made me wonder why he had not used a smaller needle to begin with. Auxiliary Nurse M returned with a smaller needle and successfully canulated my hand. I was returned to the ambulance outside to wait. 1.3.3. After being allocated a cubicle, I was left to wait for a doctor. Some time after seeing a doctor, I began to feel the urge to urinate, I called out for assistance and had my m other ask if someone could help me to use the toilet as she was not physically able to. I asked several times to use the toilet, even calling out ‘I need to go to the bathroom’ and ‘I’m going to wet myself’ multiple times. Eventually, I could not hold it in and was incontinent in my clothes. I made staff aware and at no point did anyone offer to help me change into clean clothes. 1.4. Sexual Assault by Doctor, Unprofessional Conduct of Hospital Staff: I was subjected to unprofessional behaviour, including inappropriate comments and actions, such as insensitive remarks and an episode of what I feel should be considered sexual assault, harassment or, at very least a grossly inappropriate and insensitive c onduct. 1.4.1. I was consulted by a man who introduced himself as ‘the consultant’ and stated that he was joined by ‘a registrar’. The Consultant, Consultant A was sunny and professional in his demeaner and initially seemed duly concerned for my wellbeing. Consultant A asked questions and I answered them in as much detail as I could. The Registrar, Registrar B , seemed hostile and dismissive with his only intervention being to interrupt consultant A and ask ‘What have you had done?’ I stated the name of the surgery and ask ed him if he was familiar with it, he said he was not, I proceeded to explain it, clearly indicating it as a maxillofacial surgery only. Registrar B , seeming disinterested, proceeded to then ask ‘have you had that done?’ and then poked at my groin. I am firmly of the view that this should be considered sexual assault, harassment or, at very least a grossly inappropriate and insensitive conduct. It was clearly stated by myself that the surgery was maxillofacial and at no p oint did the two doctors conduct a p hysical examination. This felt entirely inappropriate. The matter was later reported to the hospital by my companion and the nurse in charge on the following shift, Nurse - in - Charge S who reported the matter to the police. 1.5. Verbal Abuse and Abuse of Power: intimidation , unjustified allegations 1.5.1. During my time on the unit both myself and my companion were verbal ly abuse d by staff on a number of occasions. We were shouted at, threatened and subjected to unjustified false allegations, causing further distress during an already difficult time. 1.5.2. I was left in my cubicle, crying in pain, at one stage I dropped the mouthpiece to the Entonox canister on my face causing further swelling, I shouted out loudly for help but no one came. Later, my curtain was open and I called out to doctor sitting at the nursing bay for help variously and repeatedly. I kept crying out asking why I was being ignored and why nobody would look at me or make eye contact with me exclaiming “please help me” “I need to use the bathroom” “why wont anybody look at me?” “I am not a Leper ” 1.5.3. The first doctor whom I elicited a response from was a white skinned, female, redheaded doctor, Doctor C , she shouted at me, aggressively “I’m not your doctor, we’re busy with other patients, you need to be quiet” 1.5.4. the second doctor, Doctor D , a darker skinned male, seemingly of south asian background with black mid length short wavy hair said roughly the same and dismissed me when I asked to be transferred to a self propelled wheelchair so I could use the toilet. He said princess alexander do es not have self propelled wheelchairs which I know to be untrue. I proclaimed that this as false and asked if he would be willing to be recorded saying that. Another D octor, D octor N , a tall male with gasses and a strong accent charged over and said that recording was ‘ illegal ’ and he could call the police. I had not recorded anything, I merely asked if I could. Moreover, in the UK, it is not illegal to record in a public place , especially where doing so is justified for the intended purpose of protecting themselves or others. 1.5.5. I called out to another doctor, Doctor E , a white male in a black shirt with curly hair who seemed sympathetic and concerned I asked him why nobody would look at me, again explaining that I needed the toilet, he said that a nurse was coming. No nurse came. 1.5.6. After arriving back on the unit from the airport with our leftover luggage, my companion became aware of my treatment in the time she had been away including the grossly inappropriate conduct of the doctor which she strongly considered to be sexual assault. She proceeded out of the cubicle and toward the nursing bay to ask for answers. She was greeted by a male nurse, Nurse C , in a blue uniform with tanned skin, a slight frame, tattooed arms and brown hair which had been dyed blonde at the ends. Nurse C , presumably weary from ignoring me loudly wailing in pain for the last hour and a half, char ged over to her aggressively and immediately began to shout in her face “There are 20 other people in this department, we are busy! She needs to shut up because some of the patients in here are actually sick!” I intervened from my bed, telling him not to shout in her face and proclaiming that I was crying in pain. He then told me to shut up, threatened to call the police and attempted to close the curtain of my bay as I was pleading with him to have some decenc y. I called him out for trying to close the cur tain, exclaiming, “No, don’t close my curtain” and he stormed away angrily. 1.5.7. Shortly after a male nurse appeared with three security guards, he Identified himself as the Nurse - In - Charge; Nurse - in - charge A . This nurse was extremely aggressive and rude, he was shouting at my companion. He also threatened me with the police and began claiming I had recorded in the department, which I was not. I believe this was a concerted effort to abuse his power as Nurse - I n - Charge, to remove me from the unit as I was, in his view causing a nuisance. I was extremely distressed, visibly and audibly so , crying in pain and distress. This nurse, Nurse - in - Charge A was not in distress, he was in the execution of his professional duty, responding to the concerns of a concerned, crying and distressed family member and an extremely distressed patient, neither of whom were abusive, made any threats nor engaged in any be haviour that was abusive or threatening, had not called anybody any names nor sworn at anybody nor displayed any behaviours that could reasonably and objectively be conceived abusive, aggressive o r threatening. Nurse - in - charge A, in the execution of his duty, was aggressive, shouted at my companion , brought three security guards which dramatically executed the situation and were obviously intended to serve the purpose of being an intimidating presence. He made a false claim of fact and law; that it was illegal to record in public, and even went as f ar as to maliciously report this matter to the police. This is an abuse of power. Moreover, the implications of reporting myself to the police, specifica lly as a black transgender woman, are far reaching with black women, especially vulnerable black women being known to experience disproportionate subjugation to criminalisation in healthcare settings. F or myself, the falsely accused, this disproportionate exposure to unjustified criminalisation is known to and can reasonably have been foreseen to spark a deep rooted fear of extreme and even fatal police violence (such as in the widely publicised and current cases of Chris Kaba or Sarah Everard ) 1.5.8. Nurse - in - charge A ’s demeanour became even more hostile and accusatory when my companion again made reference to the allegation that a doctor had sexually assaulted myself. At this point, a second Nurse - In - Charge, Nurse in Charge B walked onto the unit before starting his shift, joined in and began shouting at myself, Clicking his fingers and shouting “She has got to go.” Challenging him, I exclaimed “And why is that?” he responded by shouting “because you’re making noise on my unit, I am the nurse in charge and I will discharge you” I maintain that I was distressed and crying not shouting although acknowledge that the two were being misconceived. “On the basis of what clinical assessment? You’ve had no involvement in my care. You’re not a doctor it is not your role to discharge me, you don’t even know why I’m here” I asked Nurse - in - charge S who then claimed that he was talking about my companion needing to leave Consultant A arrived and was denying that he failed to prescribe adequate pain relief. My Companion again reiterated her concern about her view that I had been sexually assaulted by a doctor, I reiterated that it took place in front of Consultant A . The situation deescalated as staff realised the gravity of the concerns raised, with the Nurse in charge later wheeling me outside for a quiet discussion and a cigarette and himself apologising profusely for the above described events. 1.5.9. At another point Following this, when I was later wheeled to the smoking area by my companion t o calm down, the Nurse - in - charge, Nurse - in charge A , reported to the police that I had stolen the breathing apparatus that she had been prescribed , he again made a formal report and this was unjustified as 1) this was my prescribed medication and 2) I had not left with the medication . It is not conceivable that the Nurse - in - charge did genuinely believe that the apparatus had been stolen as aforementioned, his coll eague, Nurse - in - charge S , had just wheeled me out to the same location shortly before to deescalate the confrontation and apologise. 2. Broader Implications These allegations highlight a grave concern about the hospital's dedication to providing compassionate patient care, upholding safety, and respecting human rights. It also has wider implications in the context of critical social and cultural issues related to access to healthcare, the criminali s ation of Black patients in healthcare settings , violence against women and girls and the broader implications of medical racism and transphobia in healthcare settings. I wish to draw your attention to the following b roader implications: 2.1. Disparities in Pain Management and Care Studies show that people of colour, including Black individuals, are less likely to receive appropriate pain management compared to their white counterparts, leading to undertreatment of pain (Hoffman et al., 2016) Transgender individuals often face discrimination and bias in healthcare settings, resulting in delayed or inadequate pain management after medical procedures (Grant et al., 2011). 2.2. Neglect and Dignity in Healthcare Reports reveal instances where transgender individuals have experienced neglect and disrespect in healthcare, compromising their dignity and discouraging them from seeking future medical assistance (Grant et al., 2011). Neglect of basic needs, such as assistance with toileting, can have detrimental effects on a patient's well - being and recovery, highlighting systemic issues in patient care (Kass et al., 2015). 2.3. Sexual Assault and Inappropriate Conduct in Healthcare Settings Studies indicate that transgender individuals are at higher risk of facing harassment and discrimination in healthcare settings, which can include inappropriate questioning and invasive physical examinations (James et al., 2016). Instances of insensitive and inappropriate conduct by medical professionals can result in trauma, anxiety, and a reluctance to seek further medical care, exacerbating health disparities (James et al., 2016). 2.4. Verbal Abuse and Abuse of Power Discrimination in healthcare is a significant issue, with marginalised communities often experiencing verbal abuse and mistreatment, which can deter them from accessing essential medical services (Salami et al., 2021) Abusive behavior from healthcare professionals can deepen mistrust and fear, discouraging patients from seeking care and leading to worsened health outcomes, particularly for vulnerable populations (Salami et al., 2021). 2.5. Racial Discrimination and Criminalisation: Black individuals, especially women, face racial bias in healthcare, which can lead to unwarranted criminalisation and a lack of proper medical attention, perpetuating health disparities (Bailey et al., 2017). Historical cases of racial bias and police violence contribute to a deep - rooted fear among Black individuals, affecting their willingness to engage with healthcare providers and systems (Bailey et al., 2017). 3. Impact Statement “I am writing this impact statement to shed light on the deeply distressing and traumatic experience I endured during my visit to the Accident and Emergency (A&E) department at Princess Alexandra Hospital on the 30th of September, 2023. The events of the 30/09/2023 have left an indelible mark on my life, both emotionally and physically. The appalling mistreatment and abuse I faced have shattered my trust in the healthcare system, leaving me with a profound fear and anxiety associated with seeking medical assistance. I believe it is crucial to share the impact this experience has had on me, as it echoes the larger issue of systemic discrimination and the urgent need for reform within our healthcare institutions. The incident has resulted in severe emotional trauma, leaving me anxious, having nightmares and an intense fear of medical environments. The memories of the verbal abuse, humiliation and neglect continue to haunt me, impacting my mental well - being. The del ay in providing adequate pain management and care has exacerbated my physical condition, prolonging my recovery. The prolonged suffering has hindered my ability to regain my strength and resilience post - surgery, affecting my overall health and quality of l ife. The disrespectful behaviour and lack of empathy displayed by healthcare professionals have shattered my trust in medical practitioners. I now question whether I will receive fair and compassionate treatment when seeking medical assistance in the future. The incident has strained relationships with my loved ones, who witnessed my distress and helplessness. It has created an emotional burden on my family and friends, leaving them shocked and deeply saddened by the t reatment I received. Despite the trauma, I am determined to turn this negative experience into a catalyst for change. I am committed to advocating for reforms within healthcare systems, promoting inclusivity, respect, and equal treatment for all patients, regardless of their b ackground. This incident has underscored the urgent need for comprehensive training and education to eradicate discrimination within healthcare settings. No individual should endure what I experienced, and I implore the authorities to take immediate action to prevent such incidents in the future.” 4. Desired Resolution I implore you to initiate a thorough, impartial investigation into these allegations and take appropriate actions to ensure accountability and prevent the recurrence of such incidents. I request regular updates on the progress of the investigation and the measures implemented to prevent similar occurrences in the future. My supporters and I seek reassurance that the hospital is committed to addressing these allegations transparently and will work to ensure that every individual receives safe, respectful, and dignified care, irrespective of their gender identity or background. Thank you for your immediate attention to this matter. I look forward to a prompt and comprehensive response to this formal complaint. Sincerely, GIRL C