Decision report 201103393

Summary

Mr C had a history of alcohol dependency. He stopped drinking in May 2010. His medical practice prescribed medication, including Thiamine B (a specific type of vitamin B). In 2008, Mr C had experienced ice-cold feet, severe pain and loss of sensation in his legs. In 2009, he was diagnosed with peripheral neuropathy (damage to the nerves that connect the central nervous system to the limbs) and in May 2010 he began to have seizures and tremors.

Mr C stopped taking the prescribed Thiamine B in August 2011 and found that his pain, muscular problems and seizures stopped. He complained to the practice about the use of Thiamine B and the fact that this was not reviewed following his deterioration in 2008. They told him that there are no side effects associated with this medication. However, Mr C conducted his own research and found that an allergic reaction to the medication could cause the symptoms he experienced. He also believed that his other medication had a detrimental impact on his health. He complained to us that the practice failed to reassess his medication when his symptoms developed and failed to identify that Thiamine B was causing his neurological problems. He also complained that the practice failed to refer him for a specialist opinion.

We took advice from one of our medical advisers and found that all the medication complained about was appropriate for a patient with Mr C's symptoms and history of alcohol dependency. Thiamine B in particular has a protective role in limiting damage to the nervous system should the patient continue to consume alcohol. We accepted that patients may react in unpredictable ways to any medication and recognised the symptoms that can be caused by a reaction to Thiamine B. However, we found no link between this medication and neurological problems as described by Mr C. We were satisfied that the practice held regular discussions with Mr C about his medication during a number of consultations. We were also satisfied that the practice arranged suitable tests and made appropriate referrals for investigation into the cause of Mr C's symptoms by specialist consultants.