Patient dies from blood clot after Ombudsman urges apology and careful consideration of symptoms after practice’s failure to check risk factors

APATIENT in Scotland died after they were misdiagnosed with anxiety rather than a dangerous blood clot. Anxiety can be mistaken for a pulmonary embolism, where a clot blocks arterial blood flow to the lungs.

While there are similar symptoms, GPs are meant to take account of patients presenting with multiple risks associated with a pulmonary embolism and investigate further.

In this case, the unnamed Ayrshire GP should have taken further steps as the patient – named “A” in a report by the Scottish Public Services Ombudsman (SPSO) – had multiple risks around BMI levels, use of a prescribed combined oral contraceptive and their family’s medical history.

The patient’s parent had taken the case to the Ombudsman, with concerns that the diagnosis and treatment for anxiety had led to their death.

The patient had a telephone appointment with a GP due to shortness of breath, breathlessness and feeling faint when walking upstairs and when putting on their shoes.

The patient was diagnosed with anxiety and prescribed a beta blocker – a drug that blocks the action of hormones such as adrenaline to counter anxiety.

Later that week, the patient died suddenly due to pulmonary embolism – a blood clot that blocks and stops blood flow to an artery in the lung.

There were concerns that there was a delay in receiving proper treatment due to the anxiety diagnoses and that the medication prescribed was inappropriate, leading to greater harm.

The Ombudsman’s report stated: “We took independent advice from a GP adviser and subsequently from another GP adviser with a specialism in sexual and reproductive health.

“We found that there are numerous risk factors for pulmonary embolus and, in this case, the main risk factors were BMI, family medical history and prescription of combined oral contraceptive.