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GP Negligence prescribed sleeping pills which caused urine retention and an indwelling catheter to be put in - Quality of life ruined by GP negligence!!


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Brother on prostate medication which helps him flush out urine and reduce size of prostate. His feet were swollen up so the medicine was stopped for a few weeks but his family forgot to put him back on the prostate medicine beacause during this time a family member passed away and unfortunately the family members forgot to get it removed.

 

Water rentention built up over the period the medicine was stopped and then one day my brother woke up complaining of pain in the bladder and the stomach look bigger due to water rentention.

 

Out of hours gp was called, diagosed as water rentention - advised to go hospital to get it drained and then back home on medicine.

Brother went to hospital, the 1st dr said the Catheter would be short term and taken out 2-3 weeks.

The next day the consultant came and said the Catheter was fitted to stop this happening again and the other alternative would be surgery on the prostate. He said  it was long term but the family member with my brother did not fully take on board what the consultant was telling her and she forgot to tell the consultant that

 

1. Prostate medicine was stopped due to feet swelling up and should have been restarted but wasnt and it was due to stopping the prostate medicine which caused the water rentention in the first place. The prostate would naturally enlarge during this time if no prostate medicine was given.

 

2.  His family want the Catheter removed and brother restarted on the prostate medicine before the Catheter is removed because

he is over 85 has Alzhemiers

he is struggling with it

keeps trying to pull it

he can't tolerate it keeps asking what it is

he is in discomfort.

 

He is going to the toilet himself to pass stools and knows how to pass urine but with the Catheter this is not happening.

 

His daughter suspected was not right because my brother looked more depressed and not himself and the colour of urine was yellow, so she gave his urine sample to the gp  this came back with a UTI for which he is now on medicine.

 

Hospital is saying the notes show my brother was with a long term Catheter and it seems they are not really keen in removing it, despite his family telling the hospital

 

he is over 85 has Alzhemiers

he is struggling with it

keeps trying to pull it

he can't tolerate it keeps asking what it is

he is in discomfort.

He is not himself anymore and wants it removed it

 

The Catheter  was also blocked and had to be removed and new one replaced his family can see this is causing him discomfort and distress and all they want is for the prostate meds to be restared and the Catheter then removed and see if my brother will be able to pass urine, because the prostate meds was helping him flush out the urine

 

Hospital advised to ring GP to request referral to remove, hospital say my brother would have to come in to hospital where they would then think of the options but family want my brother back on the prostate meds and then Catheter removed

 

The consultant is wrongly thinking my father was taking the prostate meds and despite this water rentetion occured and thats the consultants reasoning for long term Catheter BUT he is not aware the prostate meds was stopped weeks before causing all this to happen

 

If the consultant was aware of this to start with the Catheter  would never have been placed long term and my brother would have been sent home with meds after having the water rentention drained and back on his prostate meds.

 

Watching him suffer with the Catheter is terrible and with his age it needs to be removed

 

 

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I suspect the “retention” you refer to as “water retention” is instead “urinary retention”

 

(“water retention” from right heart failure leads to swollen ankles / legs. “Urinary retention” is when urine can’t be passed and the bladder gets painful from distension).

 

I suggest you ask the GP to restart the prostrate meds, and then see if the Consultant will review their decision. Was the Consultant a Urologist or e.g. a Physician (or Physician with an interest in Care of the Elderly) ?

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Posted (edited)

It was urinary retention, due to stopping the prostate medication but the Consultant Urologist is not aware of this. He thinks the prostate meds were being given but they were stopped weeks before and gradually over that time urine retention gradually started to build up.

 

Brothers family have explained everything to the GP who will get in touch with the consultant but the longer the Catheter the more discomfort, distress its causing.  He can't tolerate it keeps asking what it is, its very distressing to see whats happening.

 

Really need the meds restarting to work on the enlarged prostate, then 4-5 days after starting the meds the Catheter to be removed.

 

It really needs to be done ASAP

Edited by linzie
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  • 4 weeks later...

Family member with dementia, incontinence and enlarged prostrate was prescribed sleeping pills. Sleeping pills pose a problem for those with incontinence at night. The sleeping pills caused urine retention which then meant struggling with an indwelling catheter and frequent visits to the hospital A&E and blood tests on each visit.

 

GP prescribing medication should have known the side effects of the medication, should have be known from medical records that this is the case.

 

The consultant at the hospital said the sleeping pill brought the urine retention foreward. Family member has repeated UTI's since the urine rentention!!

 

The chemist did not provide a manufacturers leaflet inside the medicine box!!

 

 

 

 

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Hi

 

Couple of questions if you don't mind:

 

1. Do any of the Family Members have Power of Attorney (PoA) for the Relative in question? (if they do has that relative informed the hospital or has the Hospital if (PoA) is in place and asked for a copy of the PoA Document?)

 

2. Has the Relative with there Medical Condition been Sectioned under Adults with Incapacity (AWI) at all? (now if the hospital has an (AWI) in place they would need to notify the relativesespecially if (PoA) is in place of this and there reason for it being put in place)

 

3. Have you asked the Family GP to contact this specific Hospital Consultant and explain to them about that certain medication being stopped? (it is easy for GP's to do this)

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1.The family member has a full time carer from within the family.

2.Not sectioned.

3.Gp made aware the sleeping pills caused the urine retention.

 

The Gp prescribed sleeping pill was given at night, the next morning the patient was in discomfort. The family thought it was stomach related but it was later discovered to be urine retention by the out of hours Gp who was called in the evening.

 

This out of hours Gp told the family the sleeping pill should never  have been prescribed due to the fact the patient has dementia and this sleeping pill causing urine retention and the Gp who prescribed the sleeping made a major mistake prescribing it and why did that Gp not fully go through the patients records and realise the sleeping pills cause urine retention and for a patient with dementia this is very dangerous.

 

Out of hours Gp informed the hospital patient on way to get urine drainage. Consultant at hospital made aware sleeping pill was given and next morning urine retention happened. Consultant told patient family the sleeping pill probably did cause the urine retention and one of the side effects of the sleeping pill is urine retention.

 

Patienst family want to complain to the Gp who prescribed the sleeping pill for his negligence in prescribing the sleeping pill, which led to urine retention, which led to patient having indwelling catheter, which led to patient struggling with indwelling catheter, which led to catheter being changed 4 times in 4 weeks causing trauma, which led to bleeding into the catheter bag.  This led to goiing to the hospital to remove the indwelling catheter the day blood went into the indwelling catheter bag.

 

The Gp by his medical negligence caused Drug-Induced Acute Urinary Retention is defined as a sudden inability to urinate, which is usually painful and requires catheterization. This has impaired quality of life, and can cause kidney injury. A variety of medications used for symptom management can tribute to urinary retention.

 

The Gp by his negligence failed to realise patient had underlying dementia and elderly patients are more at risk due to increased prevalence of benign prostatic hypertrophy (BPH) and Drug-Induced Acute Urinary Retention. The Gp prescribed the sleeping pill which caused all this to happen.

 

How should the family complain in writing to the Gp surgery, is there anyone experienced enough on the forum able to help?

 

Edited by linzie
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Is your relative OK now? That's the most important thing.

 

The health ombudsman suggests trying to discuss things with the surgery first, maybe some like the practice manager. What outcome are you looking for from the complaint please?

 

https://www.ombudsman.org.uk/sites/default/files/How_to_raise_concerns_about_a_general_practice_0.pdf

 

HB

Illegitimi non carborundum

 

 

 

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Relative is not o.k, has been suffering from recurrent Urinary tract infections (UTIs) which effect the urinary tract, including the bladder (cystitis), urethra (urethritis) or kidneys (kidney infection).

 

2 different sets of Antibiotics, have been prescibed and both have failed to stop the UTI.

 

Patient still has urine retention and using a catheter, his quality of life is ruined because of medical negligence of the Gp who prescribed the sleeping pills.

 

Secondly the pharmacy which sent the sleeping pill medicine, did not include the medical instructions with the medicine. The duty imposed by law on the pharmacy who precribed the sleeping pill is to accurately fill that prescription and to notify the customer of any potential interactions between the prescribed drug and other drugs being supplied by the pharmacist to the customer - No medical instructions were inside the sleeping pill medicine the pharmacy sent.

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Would the instructions be online?

 

As I said just now, it would be helpful to know what you're trying to achieve with your proposed complaint. What would you like the surgery to do please?

 

HB

Illegitimi non carborundum

 

 

 

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The family need assistance in writing a complaint to the Gp practice manager for the medical negligence of the gp who prescribed the sleeping pills.

 

Secondly assistance in writing a complaint to General Pharmaceutical Council neglience of the pharmacy for the dispensing error on the sleeping medication which was incorrectly packaged by not including the medicine instructions inside the packet.

 

The same pharmacy has sent antibiotics for the urinary tract infection without medicine instructions inside the packet. Exactly the same thing they did with sleeping pills which caused urine retention!  The pharmacy has failed to protect patient safety and any future risks to patients.

Edited by linzie
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There's no special way to write a complaint, it's not very different to posting here and you seem to be doing fine.

 

Set out the complaint and what you want them to do about it, post it up here and we'll help you to refine it, if it needs refining.

 

You won't consider speaking to the practice manager at the surgery?

 

Also, can you tell us the name of the sleeping pills?

 

HB

 

 

Illegitimi non carborundum

 

 

 

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Medical instructions for medicine received from pharmacy which is prescribed by the gp is included with the medicine especially if the medicine is tablets in this case

 

The family will not speak to the practice manager they want everything in writing.

Name of the medicine I do not know

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Well, I'd suggest writing to the practice manager and the pharmacy manager in the first instance.

 

I know I keep asking what outcome is being sought, but to my mind an important part of writing a complaint letter is saying what you want to happen.

 

HB

Illegitimi non carborundum

 

 

 

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Have a look at the GP practice information.  See if you can find out who the Managing Partner is or most senior GP is at the practice.

 

Normally every GP practice will have someone who is responsible for dealing with complaints.

 

I think there is a way to complain to the General Medical Council about the issues you raise and to have an independent Doctor review the treatment. Have a look into this to see whether this is possible or do you need to go through Ombudsman ?

 

@BazzaS
is far more knowledgeable about everything health related, so hopefully they will comment.

 

 

We could do with some help from you.

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The practice manager and the pharmacy manager in the first instance will be sent a letter of complaint.

 

The practice manager why was this medicine prescribed given the patient has history of benign prostatic hyperplasia (BPH) that was treated with prostate medicine each morning. The sleeping pills must be avoided in patients with prostate enlargement, also known as benign prostatic hyperplasia (BPH), as they may precipitate urinary retention, which in this case has unfortunately happened. I will get the family to check medical records in case the patient was also prescribed in the past other medications besides the sleeping pills which also precipitate urinary retention. Why was the Gp negligent?

 

Pharmacy the medicine which you sent which precipitated urinary retention did not include medical instructions inside the packet and you did it a 2nd time with antibiotics for the UTI. Pharmacy complaint will go straight to the governing body which regulates pharmarcies.

 

The consultant more or less when told the patient took the sleeping pill the night before the urine retention more or less admitted the sleeping pills caused the urine retention. The family have evidence of the consultant saying this.

 

The kidney GFR levels could be effected due to a combination of the urinary retention, having the indwelling catheter, blood coming into the catheter bag, the indwelling catheter being changed 3-5 times in period of 4 week, when normally the indwelling catheter is changed every 3 months because each time the catherer is changed the risk UTI is high.  Patient has dementia and has gone  through hell since all this happened because of gross negligence of the Gp.

 

This is a serious complaint now.

How can the family get access to patients medical records in paper format?

Edited by linzie
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Has the GP seen the patient again since the problems started? I'm not clear how long this has been going on.

 

I had a quick look at the GPhC website and examples of why you would report a pharmacist. I think you mentioned Dispensing Error.

Dispensing errors

'A dispensing error could include being given out-of-date medication or medication that is incorrectly packaged or labelled. It could also include being given the wrong medication or prescription product, or the wrong dosage.'

Bazza knows a lot more about this kind of stuff than I do, but was the medication in the box what it said on the outside and was there a label saying how often to take the tablets?

I think I would have rung the pharmacy or gone in and asked for an information leaflet, although as I said they may well be online anyway.

HB

Illegitimi non carborundum

 

 

 

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Patient unable to see Gp because Gp is not seeing patients in person.

It is the responsibility of the pharmacy to dispense of medicine in a safe controlled way with instructions provided. It is not the job of the patient to go calling for a medical instruction leaflet or go looking online.

 

Pharmacy failed to include any additional warnings required with the sleeping pills, all they sent was a packet with sleeping pills, no medication instructions were provided or a warning provided that urine retention could happen.

 

The Gp has made a major mistake to prescribe the medication given the patients medical history

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I think we've understood all that.

 

I'll ask again what you want to happen. With the pharmacy, do you want someone to be disciplined or lose their livelihood?

 

And the same with the GP.

 

HB

Illegitimi non carborundum

 

 

 

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HB, you called? :)

 

For there to be medical negligence there must be:

a) a duty of care,

b) a breach of that duty of care,

c) harm resulting, and

d no intervening act or event that led to the ham (instead of it being the breach of duty of care causing the harm).

 

a) isn't an issue, doctor owes their patient a duty of care.

c) isn't hard to demonstrate, if there was no urinary catheter before, and there is one now - the GP would hjave to show that the sleeping tablets weren't the 'tipping point' for the catheter, and it was going to happen then (and not later), anway.

d) You'd need access to the notes -was / were there any intervening event(s)?.

 

b) is the issue. The leading case of Bolam stood the test of time for many years regarding breach of duty in medical negligence casses, but has now been amended with the Bolitho case.

 

https://www.lexology.com/library/detail.aspx?g=ee2ee1a1-6753-4f37-9b6f-3fbe254430bc

 

Bolam in effect says that if there were a multitude of opinions as to the cause of action, let is say A, B and C, (and D to F+), THEN even if A and B are diametrically opposed, but 48 % of practitioners would do A, 47% would do B, 2% would do C, and <1% would do D to F+), then a 'reasonable body of practitioners' would do A or B, and neither would be a breach of duty of care.

 

So, it would depend why the GP prescribed the sleeping tablets, if this was done deliberately knowing of the risk of urinary retention, in a 'I klnow there is the risk, but the likely benefit exceeds the risk' way, and if a body of their colleagues, in the sane circumstances would have done the same. It doesn't matter if another body of their colleagues would say "I wouldn't have done that" if a reasonable body still would have (back to A and B may even be diametrically opposed courses of action).

 

So, you ideally want the notes. If there is a careful record of the GP considering using the sleeping tablets even with the side effect risk, then you'd need expert opinion on if it was a reasonable risk to take  / if a body of their colleagues would have done so too.

If there is no record of it being a conscious risk/benefit based decision, it is harder for the GP to argue it was a deliberate choice, rather than they made a mistake. Most GP's use a system that alerts them when medicines may interact, but so many medicines interact with so many others that it often alerts for people on multiple meds.

 

Bolitho shifts the position, but not as much as at first glance.

It modifies Bolam, which said, in effect, it is for the responsible groups of doctors to decide. So, back to the example above, A and B were not breaches of the duty of care.

Bolitho says that even if a responsible body would do B (so not a breach under the Bolam test), if a court decides that B is 'manifestly illogical' then it doiesn't matter that a reasonable group of practitioners would do it - that no longer counts, a judge can over-ride the option of that group of professionals.

It marks a shift from 'doctors know best' to 'judges know better', but given it is rare for a group of doctors to be 'manifestly illogical', it hasn't opened a floodgate of cases where Bolitho leads to a different outcome than Bolam would have.

 

Get the notes (if you are able to act for the relative ; is there a lasting power of attorney for 'Health and Welfare) if the relative's dementia is severe enough to mean they lack competence to act for themselve)

 

Ask for an explanation from the GP's. Don't make it a complaint (yet), as if you complain to the GP's, it may mean you can't later complain to the CCG instead

 

 

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1 hour ago, BazzaS said:

...

Ask for an explanation from the GP's. Don't make it a complaint (yet), as if you complain to the GP's, it may mean you can't later complain to the CCG instead

 

 

 

 

Bazza - on a general point, are you concerned that if a complaint is made to the surgery, then it might prevent a later complaint to the CCG?

 

I used to work in the NHS (provider trust, not CCG) and in these sort of threads I generally say follow the practice's complaints procedure first, and if that gives no satisfaction complain to the CCG.  (In fact I may have given such advice only last week).

 

BTW, I'm not suggesting you are wrong, I'm just worried I may be!

 

(And this thread sounds like one where the complaint needs to be right - it's a serious one).

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The CCG (for out of hours or secondary care) or NHS England (for primary care, within hours) are the commissioners.

 

The Commisioners can look at an initial complaint (as can the practice), and MIGHT review a complaint that has already been made to a practice, but aren’t supposed to!.

 

The escalation if unhappy with a practice’s response is supposed to be to the PHSO (& they aren’t quick!).

 

https://www.ombudsman.org.uk/sites/default/files/How_to_raise_concerns_about_a_general_practice_0.pdf

 

So NHS England / the commissioner doesn’t fit as a second stage within the NHS’s complaints flow chart. There are meant to be two alternative first stage options, with the PHSO as the second stage.


most practices don’t know this! (And depending who you get in NHS England they might not either!!).

Even if the practice does know : they might not argue (given they probably don’t want a complaint to NHS England, but don’t want it going to the PHSO even more!)

Edited by BazzaS
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The consultant at the hospital said the sleeping tablets were the 'tipping point' for the urine retention aka the spark and it was going to happen sooner or later and the sleeping pills pushed it foreward but he later put the blame on the enlarged prostate in the same conversation. This is on audio!!

 

Is it medical notes that need to be requested from the GP?

 

ATM there is no lasting power of attorney for ('Health and Welfare) the family were not aware of this.

 

It appears the Gp surgery has prescribed other different medicines in the past which can cause urine retention in some one which an enlarged prostate.

 

How would you suggest making the initial complaint?

 

Edited by linzie
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Hi

 

Those relative looking after the relative with Dementia really need to get Power of Attorney (PoA)/Deputyship in place so they need to speak to the Public Guardians Office on how to proceed with this for not just Health and Welfare but Financial as well:

https://www.gov.uk/government/organisations/office-of-the-public-guardian

 

Has the relative with Dementia actually been properly Diagnosed and the medical condition and confirmed by the Hospital (not a GP)?

 

As this is to do with the GP at the Doctors Surgey IMO you would firstly need to make your formal comlaint in writing to the Practice Manager of that specific Doctors Surgery and await the outcome of there decision and if not happy to then progress it further. 

 

Please wait for BazzaS to pop in they are more knowledgeable in this specific area

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I cannot give any advice by PM - If you provide a link to your Thread then I will be happy to offer advice there.

I advise to the best of my ability, but I am not a qualified professional, benefits lawyer nor Welfare Rights Adviser.

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