Decision Report 201604254

Summary

Ms C complained on behalf of her mother (Mrs A) about the way her medical practice managed the medication for her thyroid condition. Mrs A had a condition called hypothyroidism (where the thyroid gland is underactive and does not produce enough thyroxine hormone) and had received treatment for this for a number of years. Mrs A had attended the practice for a blood test to measure her levels of thyroxine. When the test results showed that her thyroxine level was too high, a GP at the practice advised Mrs A to stop taking her thyroxine replacement medication and to attend the practice in six weeks to have the levels checked again.

Shortly before Mrs A was due to return to the practice, she had a seizure and was hospitalised. Doctors at the hospital concluded that the seizure was caused by profound hypothyroidism following the withdrawal of thyroxine medication. Ms C complained that the medication should have been reduced more gradually and that follow-up tests should have been arranged sooner than they were. She also complained that Mrs A was not informed of the side effects of withdrawing the medication.

We took independent advice from a GP adviser who said that there were a number of risks associated with high thyroxine levels. In view of this, they considered that the GP's decision to cease thyroxine medication and review Mrs A in six weeks was reasonable. They did not consider that Mrs A's rapid development of hypothyroidism followed by a seizure was predictable, and noted this was a rare complication of her condition. While there was no evidence that discussion of side effects had taken place, the adviser did not think it was unreasonable had the GP not discussed the rare complications of a seizure in the circumstances of this case. We did not uphold this complaint.