Decision Report 201400350

Summary

Mr C complained that the care and treatment of his wife (Mrs C) had been unreasonable, in particular in relation to managing Mrs C's stiffness and contractures (rigidity in a joint that cannot be overcome, leaving the limb in a fixed position). Mrs C, who suffered from dementia, was initially cared for at home under the care of a speciality doctor in old age psychiatry and her GP. However, when there was a marked deterioration in her mobility and rigidity in her limbs, she was admitted to Victoria Hospital. A month later, she was transferred to Queen Margaret Hospital. During this time, as Mrs C was becoming increasingly agitated and upset, she was prescribed increasing doses of an antipsychotic drug (a medicine used to treat mental health conditions). Mr C complained that this resulted in his wife's physical condition deteriorating and her body becoming more rigid.

We took independent medical advice from two of our advisers - consultants in old age psychiatry and in geriatrics - and we found that while it was known that the drug prescribed to Mrs C might have side effects causing muscle contractures, in Mrs C's case it was initially prescribed to her in a low dose to reduce her agitation. This had been fully discussed with Mr C. We also found that the clinical staff involved considered the benefits of using the drug against the possible side effects, and concluded that the benefits outweighed the possibility of any side effects. It was also known that many patients with end-stage dementia went on to develop contractures. While Mrs C was given increasing doses of the drug, the matter had always been discussed with Mr C and clinicians followed good practice by continually monitoring Mrs C. We did not uphold Mr C's complaint.