Decision Report 201800018

  • Case ref:
    201800018
  • Date:
    August 2019
  • Body:
    A Medical Pactice in the Grampian NHS Board Area
  • Sector:
    Health
  • Outcome:
    Upheld, recommendations
  • Subject:
    clinical treatment / diagnosis

Summary

Mr C complained on behalf of his mother (Mrs A) about the care and treatment Mrs A received at the practice. Mrs A attended the practice complaining of flu-like symptoms and was prescribed a particular antibiotic. That evening she became nauseous and started vomiting. Mrs A's condition deteriorated and she was admitted to hospital three days later with dehydration and acute kidney injury. Mr C was concerned that the practice had prescribed a certain type of antibiotic to Mrs A despite her medical history and about the effect this had on her.

We took independent advice from a GP adviser. We found that Mrs A should not have been prescribed the particular antibiotic and that it was almost certain that this aggravated Mrs A's dehydration and acute kidney injury. Mrs A should also have been advised to stop taking other medication until the diarrhoea and vomiting had resolved. We upheld the complaint.

Recommendations

What we asked the organisation to do in this case:

  • Apologise for the failings around the prescription of the antibiotic. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

What we said should change to put things right in future:

  • All of the relevant healthcare professionals at the practice should reflect on this complaint and its findings in their next appraisal.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Updated: August 21, 2019