Bipolar disorder is a relatively common mental illness that is characterised by periods of very low moods or depression, contrasted with very high moods or mania. Many people have become increasingly familiar with the disorder due to its portrayal in the Stacey Slater character in the popular soap “Eastenders”.
One of the drugs used to stabilise the mood is Lithium. This is an extremely effective treatment and a number of patients remain on lithium for many years. However, it is important that the blood level does not get too high as it can then become toxic. As the level becomes higher, the patient may suffer with symptoms such as diarrhoea, vomiting, confusion and dizziness. If the level becomes higher still, the patient may suffer seizures, pass into a coma and suffer irreversible neurological damage. For these reasons, it is very important that levels of this drug are monitored with blood tests, especially after starting new medicines.
In a case from the MPS casebook, a patient in her forties (Mrs L) was newly diagnosed with Bipolar Disorder and started on lithium by her psychiatrist. When her lithium levels were stable, after several changes in dose and regular monitoring, she was discharged back to her regular GP, Dr G.
At some point over the next four years, Dr G started the patient on a new medication – a water tablet that may cause lithium levels to rise. No testing was carried out after this new drug was started. Her regular repeat prescriptions continued and, a year later, Mrs L was seen by another GP at the practice, having developed constipation and shaking. She was prescribed a sedative drug, Diazepam, and no further action was taken.
Two days later, she was seen on a home visit by another GP from the practice, who noted that the patient was no longer able to stand and appeared more confused. He organised a non-urgent blood test and review with psychiatry, within 2 months. However, the next morning her husband took her to A+E and she was promptly diagnosed with lithium toxicity.
A claim at court was brought for Mrs L’s sufferings. She had gone into a 3 week coma and been left with slurred speech and memory problems as a result of the GP’s negligence.. Experts agreed that the patient had received poor care, especially with regard to unsafe repeat prescribing, and the case was settled for £28,000.
This case highlights the dangers of repeat prescribing systems. It is important that GPs have systems in place to ensure the safe monitoring of potentially dangerous drugs. In addition, it is crucial that they are aware of the symptoms of toxicity in patients taking them.
If you feel that you have suffered as a result of repeat prescribing with no real monitoring by the medical practitioner, you may have a claim for clinical negligence and we suggest that you call a firm of specialist solicitors to discuss the history of your problems.
