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Case ref:201508409
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Date:December 2016
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Body:Greater Glasgow and Clyde NHS Board
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
Mrs C complained on behalf of her son (Mr A), who was admitted to the Royal Alexandra Hospital with kidney failure and physical collapse. He was transferred to the Western Infirmary and was diagnosed with neuroleptic malignant syndrome (NMS), a rare condition caused by some medications (particularly antipsychotics). Mrs C was concerned that Mr A's overall treatment pathway for the previous ten years led to his collapse. In particular, Mrs C felt that the clinicians treating Mr A had inappropriately used strong antipsychotic drugs and had not taken into account Mr A's particular risk factors in relation to his medication. Mrs C also felt the board had ignored alternative treatment options for Mr A, including an alternative diagnosis of an anxiety disorder. Mrs C also complained about the board's handling of her complaint to them.
The board met with Mrs C and wrote several letters in response to her complaint and further queries. While the board acknowledged the severe impact of NMS on Mr A, they said that NMS is a rare and unpredictable event, and they considered Mr A's treatment was appropriate in view of his chronic psychotic illness. The board noted that Mrs C disagreed with clinicians about Mr A's diagnosis.
After taking independent psychiatric advice, we did not uphold Mrs C's complaints. While we found that Mr A's NMS was caused by his medications, the adviser explained that the risk of NMS was very small and the decisions made about Mr A's medication during this period were in line with the relevant guidance and standard practice. We found no evidence that the board had failed to consider Mr A's particular risk factors or the alternative diagnosis suggested by some clinicians. While we acknowledged that Mrs C was not satisfied with the board's response to her complaint, we did not find any failings in their complaint investigation or replies.