Decision report 201203298

Summary

Mr C suffers from ulcerative colitis (a disease where inflammation develops in the large intestine). When he became unwell, his GP advised him to go to the accident and emergency department. Mr C was admitted to hospital and given an intravenous steroid (a drug used to treat inflammation, introduced directly into a vein) while awaiting a gastroenterology (digestive system and its disorders) review. After the review, because Mr C was eating and drinking, the doctor who reviewed him prescribed the steroid in oral form (to be taken by mouth). After a discussion with the hospital pharmacist, the doctor noted that before Mr C was admitted to hospital, he had been taking a different oral steroid. The doctor, therefore, changed the prescription and put Mr C back on the steroid he had been taking before admission. Mr C was unhappy with this, as he felt that steroid had not been helping him, and he discharged himself from the hospital.

As part of our investigation we took independent advice from a medical adviser. The advice we received indicated that it was appropriate to give intravenous medication after admission to hospital, until tests are carried out and it is established that the patient can tolerate oral medication. The adviser also confirmed that the decision to re-prescribe the steroid that Mr C had been taking prior to admission was reasonable, as the effects of both steroids were similar.