Decision report 201200254

Summary

Mrs C had a complex medical history including pelvic, back and shoulder pain, arthritis, kidney problems, ovarian cysts, endometriosis, hypertension, depression and gastric problems. Over the course of 2009 to 2012 she attended her medical practice for pain management and treatment of these and other illnesses. GPs referred her to a number of specialists for treatment and exploratory tests, including consultants in neurology, neurosurgery, pain management and gynaecology. GPs also prescribed Mrs C with various drugs to treat her pain symptoms, including a number of different types of opioid analgesics (pain relief that acts on the central nervous system), but with limited success.

In July 2011, Mrs C became very unwell with dizziness and weakness and was confined to bed. A GP diagnosed severe postural hypotension (a drop in blood pressure than can cause dizziness), which they considered was likely to be drug-induced with inactivity contributing to it. They advised Mrs C to reduce her intake of opioid medications. During a hospital admission, specialists noted that Mrs C had a decreased level of a particular hormone and carried out extensive tests. These established that she was suffering from drug induced suppression of another hormone. Mrs C complained to us that between 2010 and 2012 the practice did not provide her with appropriate care and treatment.

As part of our investigation, we obtained independent advice from our medical adviser, who said that this is a recognised, but rare side-effect of long-term opioid analgesic use. However, he advised that the treatment that the practice prescribed for Mrs C was appropriate, and was taken with the appropriate secondary care advice, and that the referrals made were reasonable. We, therefore, did not uphold this complaint.