Decision Report 201300910

Summary

After Mr C'’s daughter (Mrs A) experienced several episodes of breathlessness, she was seen by her GP, who concluded she had a virus. Over the following days, Mrs A remained breathless. She collapsed at home and her GP was called out. He found that her blood pressure was low, but rising. He concluded that she had had a vasovagal episode (a temporary loss of blood to the brain) but was improving. Mrs A had further collapses over the following days and was eventually taken by ambulance to hospital. Shortly after arriving there, Mrs A collapsed again and, despite attempts to revive her, she died. Mrs A was found to have had a pulmonary embolism (a blockage in the artery that transports blood to the lungs). Mr C felt that Mrs A’'s GP could, and should, have diagnosed Mrs A'’s pulmonary embolism or could have arranged for more urgent investigations to establish the cause of her symptoms.

We took independent advice on this case from one of our medical advisers. We found that, with the benefit of hindsight, it was likely that Mrs A’'s collapses at home were caused by initial smaller thromboembolic (blocking of a blood vessel by a blood clot) events. However, there was evidence to suggest that Mrs A was also suffering from a viral infection, which may have contributed to her symptoms. We accepted the adviser's view that Mrs A’'s symptoms were consistent with a viral infection rather than a pulmonary embolism. There was clear evidence that the GP had considered a number of possible diagnoses but had ruled out pulmonary embolism. Based on the information available to him at the time, we were satisfied that his examinations of Mrs A were thorough and his conclusions reasonable.