Decision Report 201704787

Summary

Mrs C complained about the care and treatment provided to her late husband (Mr A). Following surgery to remove a tumour on this lung, Mr A was treated for atrial fibrillation (AF - an irregular and usually rapid heart rhythm) with amiodarone (an antiarrhythmic drug). Mrs C complained that the board unreasonably prescribed amiodarone as a first line treatment for Mr A's AF. Mrs C noted that patients prescribed with amiodarone after thoracic (chest) surgery are vulnerable to side effects, and she considered Mr A would have survived had a less dangerous drug been used to treat him.

We took independent clinical advice from an adviser. We found that guidance supported the use of amiodarone at the time of Mr A's treatment as it is the drug most likely to restore normal heart rhythm and thereby avoid the consequences of low blood pressure, heart failure or stroke, and its use remains common. We acknowledged that amiodarone may not always be the most appropriate first line treatment option in all cases of AF, however, we were satisfied that it was reasonable for medical staff to reach the view that the benefits of treatment with amiodarone outweighed the risks in Mr A's case. Therefore, we did not uphold Mrs C's complaint.

However, we provided some feedback to the board that, despite referring to it on a number of occasions in their response to Mrs C's complaint, they did not have a written protocol on treating post-operative AF following lung surgery. We suggested the board may wish to review their practice on the routine use of amiodarone as a first line therapy in all cases of post-operative AF, and consider producing a protocol on the management of AF after thoracic surgery. We also provided feedback with respect to the content and lack of accuracy of the board's response to Mrs C's complaint and invited the board to make a further apology to Mrs C having reflected on the findings of our investigation and feedback with respect to their complaints handling.