Decision Report 201502531

Summary

Mr C complained about the care his mother (Mrs A) received from the Scottish Ambulance Service (the ambulance service). Mrs A had a history of vertigo and migraine but she had been recently advised that she had symptoms of having suffered a transient ischaemic attack (TIA, often referred to as a mini-stroke, where blood supply to the brain is interrupted). Mrs A's GP had advised her to stop taking her migraine medication.

When Mrs A collapsed, her husband (Mr A) called for an ambulance. The crew arrived, assessed Mrs A's condition and decided against hospital admission. The crew believed Mrs A had suffered a migraine and advised her to take her medication, despite being informed her GP had told her to stop taking it. Six days after this Mrs A suffered a stroke. She died two days later.

Mr C complained about the ambulance service's decision not to transport Mrs A to hospital. We took independent advice from a medical adviser who is a GP. They said that there was enough evidence to give suspicion that Mrs A had suffered a further TIA and conclude that she required hospital assessment. The adviser also commented on the crew's advice to Mrs A to take her migraine medication. The adviser said this was unreasonable and outside the scope of their expertise. The adviser said that non-prescribers should not advise patients to take medication without medical advice, particularly medication recently stopped by the patient's own GP. We upheld the complaint and made recommendations.

We also identified problems with the way Mr C's complaint was handled. We were not given evidence that the recommendations made by the ambulance service during their own investigation had been carried out. We also noted that when Mr C raised new questions with the contact listed on the ambulance service's final response letter, that person declined to correspond on the complaint further. We did not believe this to be reasonable.

Recommendations

We recommended that the ambulance service:

• apologise to Mr C and his family for the failings identified in this letter;
• provide us with the outcome of their own recommendations;
• review the role of named contacts at the end of complaints letters; and
• remind non-prescribers of their role in advising patients on medication.