Do I have grounds for a complaint after my dad's treatment?

[itchyandscratchy]

My lovely dad who's getting on a bit now (84) has always been sharp as a tack and very capable physically. He had a heart attack 10 years ago and had been on warfarin ever since and was told he'd have to take it for the rest of his life. Since then he's taken it a bit easier but was still very active and healthy.

In June last year he had a prostate op and had to stop taking warfarin whilst he was in hopsital. but after he was discharged he noticed that he had not been put back on warfarin. He brought this up with his GP at his later check up but the GP didn't do anything about it (half think they thought my dad was a bit doddery and ignored him )

At Christmas he complained of severe shortness of breath and at the same time developed a problem with his legs and found he couldn't walk very far any more: they just 'wouldn't work properly' as he put it. He went back to the GP who referred him for an ecg as he thought dad had an enlarged heart but didn't think the walking problem was related. But even so he was referred for some physio.

The ecg appointment wasn't until last week so they obviously didn't think it was that urgent, considering he saw the GP at the start of Jan. His walking got worse and he started using a stick (which he'd found in his garage, left by who-knows). I went with him for the ecg this week and he found it so hard to walk that I ended up pushing him in one of the hospital wheelchairs.

Doctor doing the ecg called me to tell me he'd found a large blood clot on dad's heart and he needed an urgent appt with his GP to get back onto warfarin. Doc also said he was pretty sure Dad had had a stroke, which explains the walking problem. He gave him some emergency meds right there but we saw the GP the next day.

Obviously the main thing at the moment is to make sure dad is ok: he's having a community nurse in every day to inject him with something else to thin his blood as well as the warfarin, and he's been referred for physio to visit in his home, so at least he's now getting treatement. But how come no-one thought to put him back on the warfarin which could have avoided this stroke? Who's fault is it, if anyone's? I would like to make a complaint if it's appropriate, mainly to highlight this with the GP/Healthcare Trust and make sure this doesn't happen again with other patients.

I feel like we came really close to losing him through this. He's not out of the woods just yet but it was a close shave.

bump

thank you so much. I have an appointment to speak with the practice manager on Monday. I'd just really like to know if it was the hospital's responsibility to check his meds on release or the GP's to follow it up.

was he given any other meds instead of warfarin....aspirin or clopidogrel.normally when a patient has been in hospital on medication they are sent out with a list of their meds and it is faxed to GP surgery. The hospital should have checked his meds prior to being discharged and if he has had a gp visit or appt it should have been queried then.Normally i believe once you are on warfarin it is rare to come off it.

It was under the illusion it should be shared care or thats what you would hope for.

I hope your dad is ok as soon as poss.

If you want to make a formal complaint on your father's behalf you will have to have his permission to do so, so do check how he feels about that. Of course that doesn't mean you can't raise the issue with the practice manager and talk to PALS, just if you want to take it further than that. From what you have said, it sounds like it is the practice that you probably should be directing the complaint to, as they had the ongoing care, and it sounds like they didn't follow up on his medication query, when they should have checked his records and had the Warfarin restarted. Of course you can also ask the hospital why he didn't have the Warfarin on his medication list after the op, but it might not be their responsibility - you could try asking the PALS team at the hospital (this will be different from your PCT's PALS) if they coudl find out for you.

I hope that he makes a very good recovery.

Thanks for this- I'm very grateful

I've seen his release docs from the hospital and he definitely wasn't on any blood thinners. He can't take aspirin (allergy) and he's been on clopidogrel before so we recognise the name.

My dad says he did raise it with the GP but nothing was said about it. It seems as if it was definitely an oversight by the hosp and GP.

Trouble is, my brother is fuming about it and looking for someone to blame. He is very upset and also lives abroad so I'm aware he's channelling his frustrations at being away into getting angry and trying to apportion blame. But I don't want to take any energy out of supporting my dad at the moment by chasing a complaint. If he'd died then it would be different; but he didn't, thankfully.

I will raise this next week, but mostly so that a)they review their practice and also b)they are perhaps a bit more vigilant with dad's continuing care and it keeps them on their toes a bit.

btw, what does PALS stand for? and who is it run for and by?

PAtient Advice Liaison Service. All hospitals have one.

Don't suppose you or your dad has a copy of his discharge summary from when he was discharged after his prostate op?

It would be reasonable for him to be seen by the anti-coag team after his op and for his warfarin to be restarted by them at that time. whether there was a reason for not restarting it should be on the discharge paperwork.

Yes we do have that. There is nothing at all on there about his need for warfarin, nor a reason why he should be kept off it. Prior to the op he was passing a lot of blood in his urine and he was told to get off the warfarin, which is entirely understandable.

However, surely there should have been some sort of review set for a while after the op to see if he could be put back on it at a suitable date?

Yes. it seems that somewhere along the line somethng has been missed.

Contact PALS and definately see what the practice manager has to say.

Thanks so much.

District nurse has just phoned from dad's to say she can't get any blood today and we have to take him to a&e to get it instead. Dh has just gone