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Selected Investigations Completed December 2000March 2001 > Part I, Case no. E.263/00-01
Complaint against: St George’s Healthcare NHS Trust
Summary of case
The Ombudsman did not uphold a complaint from Mrs X that an inappropriate combination of anticoagulant drugs had been prescribed for her husband. Mr X had been taking Warfarin for years after a heart valve replacement and had been warned never to take Aspirin at the same time. When he needed surgery to a coronary artery in 1999, Aspirin and another drug affecting clotting were also prescribed. Mr X died about two weeks later from a brain haemorrhage. The Ombudsman took clinical advice, which said that the combination of drugs was appropriate in Mr X’s case. The risk of a clot forming in the artery or the valve without the drug treatment was greater than the risk of a haemorrhage with the drugs. The Ombudsman therefore did not uphold a complaint about the prescription and monitoring of the drugs. However he upheld a complaint that Mr X had not been adequately informed of the risks. The Trust apologised and agreed to review their booklet about the surgical procedure to see whether information about risk of bleeding should be included. They also agreed to remind staff to discuss risks of drug therapy before patients are discharged and note that in the records.
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