Out-Of-Hours Health Service Criticised Over Patient Who Died In Agony

An out-of-hours health service that saw a GP prescribe painkillers to a patient who died in agony a few hours later has been criticised.

Professor Alice Brown, Scotland’s public service Ombudsman, ruled a receptionist did not pass on vital details while a doctor failed to ask relevant questions in a phone consultation.

This led to the victim being told to take paracetamol less than three hours before he died from acute haemorrhagic pancreatitis at Edinburgh Royal Infirmary.

Professor Brown’s ruling that the poor out-of-hours service from NHS Lothian contributed to his death followed a complaint by the patient’s fiancée. The man, listed as Mr A, became ill on 26 April, 2004, suffering severe stomach pain and vomiting. His fiancée called NHS Lothian’s out-of-hours service, which was operating at the time, on three occasions that night.

He was first spoken to by a doctor, who called a colleague out. The visiting GP diagnosed gastroenteritis, gave an injection to ease the vomiting and advised him to call back if the pain worsened.

Early the next morning, the fiancee called an NHS Lothian receptionist after Mr A started experiencing worse pain, shallow breathing and a rapid pulse.

The receptionist referred the patient’s notes to a third GP with a note stating “friend calling, patient has intracable (sic) stomach pains”. Without knowing about his worsening condition, the GP called, asked several questions and told the patient to take paracetamol and call back if there was no improvement.

Prof Brown said the doctor simply relied on the symptoms described by Mr A, rather than identifying there had been a potentially deadly deterioration.

She upheld the complaint the receptionist had not accurately passed on all the relevant clinical information provided by Miss C, and that the final GP had failed to obtain relevant information.

The out-of-hours service is now operated by NHS 24.

Prof Brown said the complaint should be used to train out-of-hours staff and that the dead man’s fiancée should receive an apology.