Natalie Dyke, 21, from Caerphilly, lives with autism, learning needs and idiopathic intracranial hypertension, a condition caused by raised pressure around the brain which can be life‑threatening if untreated.
Her neurologist set out a clear written plan for a lumbar puncture at the Royal Gwent on 4 December 2025, including diazepam before the procedure to manage Natalie’s anxiety and stimming so the test could be carried out safely.
When she arrived, the lumbar puncture was performed not by her usual specialist but by another hospital worker.
The family claim he dismissed the plan and refused to give diazepam, telling them it “would be fine” without the medication, before attempting the procedure repeatedly for almost an hour with no sedation.
According to Natalie’s mother, the healthcare professional tried to access her spinal fluid around seven times in different positions as Natalie shook uncontrollably, sweated and cried out with severe shooting pains.
Mid‑procedure, she says he asked Natalie to sit upright while the needle was still in her back, then lie down again, but no cerebrospinal fluid was obtained.
The family say he eventually abandoned the procedure and told them it had failed because Natalie had a “curved spine” and might never be able to undergo a lumbar puncture again.
An MRI scan arranged afterwards found no spinal curvature, they say, and a written record for the procedure stated only two attempts had been made, not seven.
A few days later, another clinician contacted the family to ask what had happened and whether Natalie had received the planned diazepam.
When told she had not, he invited them back, carried out a further lumbar puncture himself using diazepam and completed it successfully.
The family say this third doctor later told them the medic who carried out the failed procedure had been suspended from performing lumbar punctures pending an internal investigation.
Since December, Natalie has been left with constant back pain, reduced mobility, nightmares and worsening mental health.
Her antidepressant dose has been increased and she now struggles to walk or stand for long periods, her mother said, describing the experience as “traumatising and humiliating”.
Her mother submitted a formal complaint under the NHS Wales “Putting Things Right” process, but four months on the family say they have still not received a final written outcome setting out what the investigation found, what action has been taken or how the health board plans to stop anything similar happening again.
They say they have since been told the medic is back performing lumbar punctures at the Royal Gwent and allege he has been telling colleagues he is “safe” and that “nothing is going to happen” to him.
Aneurin Bevan University Health Board confirmed that the clinician at the centre of the complaint is a Physician Associate and set out its position on how such staff should present themselves and what procedures they can carry out.
The board said it expects all staff to introduce themselves to patients with their name and role, and that Physician Associates wear a distinct purple uniform to distinguish them from doctors.
It added that the role is now “well established across Wales and the UK”.
On whether PAs should be doing lumbar punctures, the Health Board drew a distinction between its own policies and the BMA’s “Safe Scope of Practice” guidance, which places lumbar puncture in a red‑box list of invasive procedures that Medical Associate Professionals such as PAs should not undertake, even under supervision.
A spokesperson for Aneurin Bevan UHB said:
“The British Medical Association is a trade union, and its guidance represents perspective rather than regulatory standards set by a statutory body. For this reason, health boards are not required to formally adopt BMA guidance.
“Instead, we operate within national regulatory frameworks and have an organisational Standard Operating Procedure in place which sets out the agreed scope of practice for Physician Associates working within the Health Board.
“The organisation has a clinical policy governing the performance of lumbar puncture procedures by trained non‑medical clinicians for extended scope of practice. This provides clarity around training and sign‑off for scope of practice and aligns with General Medical Council recommendations around accountability and responsibility.
“Physician Associates play a vital role in supporting patient care across the NHS, and we will always support them to work safely, appropriately and within clearly defined scopes of practice.”
“Patient safety remains our absolute priority and we will continue to review and strengthen our policies to ensure the very best standards of care.”
The health board previously told the Argus:
“We’re very sorry to hear that Ms Dyke and her family are unhappy with the care she received.
“Whilst we aim to conclude investigations within 30-working days, there are some instances where more complex cases may take longer than this. Investigations can take anywhere up to six months to conclude, which is outlined within the national Putting Things Right regulations.
“We recognise that awaiting a response can be upsetting and frustrating and we are working to conclude our investigation and respond to the family as quickly as possible. While the investigation is still ongoing, it would be inappropriate to comment further.
“We are committed to adapting to the additional needs of our patients by providing safe, person‑centred care and ensuring that reasonable adjustments and agreed care plans are implemented, particularly where invasive procedures are required.”