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4 March 2016, 06:45
An NHS trust in Hertfordshire has been found to have mis-diagnosed a patient with schizophrenia and gave her medication she didn't need for many years.
The side effects from that were so bad the patient couldn't work.
The female patient was eventually taken off the drugs more than a decade later and the Health Service Watchdog found no basis for her diagnosis and the trust has paid her more than £7,000 compensation.
The patient complained she was incorrectly diagnosed with schizophrenia and given medication unnecessarily for many years. She felt that side effects from the medication meant she was unable to work.
Her GP referred her to the Trust having suffered symptoms of depression. The GP noted in the referral that he felt (patient) as becoming increasingly agitated and detached from reality.
A psychiatrist at the Trust saw (patient) and found that she met the criteria of a major depressive episode. He noted that she had recently given in her notice at work. The plan was for her to continue with antidepressant medication, and see her community psychiatric nurse (CPN) once a week.
The psychiatrist at the Trust also saw (patient) a number of times on an emergency basis. He recorded she was suffering from delusional thoughts. In addition to her antidepressant medication, he prescribed her an antipsychotic drug. Between spring and summer 2000, (patient) was admitted to hospital twice after taking an overdose. She was noted as having a diagnosis of major depression with psychotic symptoms. Her discharge letter stated paranoid schizophrenia.
On the second occasion (patient) was given depot, an antipsychotic medication. The Trust carried out a review in mid-summer 2000 and noted that she had no evidence of psychotic symptoms. Another review also found that she was doing well and had no significant symptoms of a psychotic disorder.
Over the following years, she continued with antipsychotic depot and oral medications and was seen regularly by her
CPN. She was also regularly reviewed by junior psychiatrists at the Trust. She remained well and was eventually taken off all medication in 2011.
The patient complained to the Trust in 2012 about a number of issues. However, she felt that the Trust did not deal with her complaint appropriately and so she brought it to us.
The Parliamentary Health Service Ombudsman found:
"We thoroughly examined the medical records and could find no basis for the diagnosis she was given. We felt that she should have had a different, slightly less serious diagnosis. We did not believe that the medication she was given was inappropriate and neither could we conclude that the side effects from this caused her inability to work. However, we found that she suffered an injustice from the impact the incorrect diagnosis had on her. Such a diagnosis may have led (patient) to perceive herself as more unwell than she actually was, which could have disempowered her, leading her to live a more restricted life than she otherwise might."
In a statement to Heart the Hertfordshire Partnership University NHS Foundation Trust says:
"We acknowledged the error in the incorrect diagnoses and contributed fully to the investigation, accepting all the findings and unreservedly apologised again to (the patient).
Since (the patient's) original diagnosis in 2000 the Trust has introduced among other things, an electronic patient record, better review processes and improved the information provided to service users and their relatives about how to request a second opinion should they wish one.
This means this situation is unlikely to be repeated. "