Article

From the TS&P casebook - diabetic comas from prescription error

Mrs B had suffered type 1 (insulin dependent) diabetes for many years. In June 2001 her general practitioner mistakenly prescribed Humalog Mix 25 rather than her usual Humalog insulin. Despite numerous attendances at the surgery and review at the hospital diabetes clinic the error was not spotted until two and a half years later.

During this period the claimant suffered severe hypoglycaemic episodes and was frequently attended by her neighbour in the middle of the night. She coincidentally suffered a number of other problems including rheumatoid arthritis, ischaemic heart disease and her health deteriorated very dramatically. When she was restored to the correct medication she enjoyed a marked improvement.

She complained to the surgery and the general practitioner who had made the initial error wrote a letter of apology.

Mrs B had a legal expenses insurance policy but the insurer refused to support the case and only did so after many months of argument and a threat to refer the matter to the ombudsman. The case was complicated both by the length and complexity of the claimant’s history of diabetes and also because she suspected that a number of other problems were aggravated by the misprescription.

We obtained a report from a consultant diabetologist who found that the misprescription had been responsible for the aggravation of her hypoglycaemic episodes and although it was not responsible for the claimant’s other health problems it nonetheless played a part in her general deterioration during this time.

We experienced unexpected difficulties in dealing with the defendants representatives. The general practitioner who made the initial error had retired from the surgery and failed to answer any correspondence. Although he was thought to have been a member of the Medical Defence Union at the time the error was made, the MDU refused to confirm whether or not this was the case. After many months of correspondence the MDU and Medical Protection Society finally conceded that they would accept responsibility for the error, subject to proof of causation, on the basis that the doctors at the surgery were jointly responsible pursuant to partnership law.

We understand that the MDU and MPS took no steps to obtain their own evidence. Nonetheless our causation evidence was challenged and at one point they alleged that the hospital was also liable. Following negotiations the case settled for £9500.

Comment

Even with an admitted error, cases can turn out to be more difficult than expected. The complexity of the patient’s clinical presentation led the defendants to challenge our case on causation even when supported by expert evidence. We are usually able to work with the MDU and MPS very constructively but on this occasion we found their stance singularly unhelpful. This may have been occasioned by the attitude of the prescribing GP.

For further enquiries please contact Graham Bell (view full profile) on 01892 701358 or email graham.bell@ts-p.co.uk.

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