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Chamber

Plenary, 01 Oct 2008

01 Oct 2008 · S3 · Plenary

Item of business

Action on Thrombosis

Godman, Trish Lab West Renfrewshire Watch on SPTV

Katie was 23 years old when she died of deep vein thrombosis. She had tried three times to get treatment, in two hospitals and from her general practitioner. She knew the symptoms. A friend of hers had written a thesis on DVT, which they had gone over line by line. Edinburgh royal infirmary carried out a venometer test, which showed a restriction in her left leg. A second test—a venogram—proved inconclusive. Katie was sent home. Why was no ultrasound or D-dimer blood test performed to be absolutely sure? Katie had tried to get help on 17 January. On 25 January, her father picked up a medical certificate that stated:

"Severe left calf pain—query DVT?"

Twenty-four hours later, Katie's self-diagnosis tragically proved to be correct. After Katie's death, the procurator fiscal concluded that Katie had been properly treated. Strangely enough, two months later, Edinburgh royal infirmary—the first hospital that she attended—changed its procedures for diagnosing DVT.

So what can we learn and what can we do? The key issue is to raise public awareness and to improve clinical practice. Both the public and the medical profession appear to underestimate the risk. Most people to whom I have spoken think that people get DVT if they have been on a long plane journey. That is wrong. Being a smoker, being over 40, being overweight, having an inherited blood-clotting disorder, having had major surgery and—most certainly—having been inactive for some time are just some of the possible causes.

Hospital protocols differ, as we saw in Katie's case. Should they not be the same? Surely if there is any doubt, further tests should be automatic. After Katie's parents made representations to the Public Petitions Committee and the Scottish Public Services Ombudsman reported that several hospitals were failing to diagnose DVT, the Government funded Lifeblood: The Thrombosis Charity to produce an information leaflet. Every GP practice in Scotland received one. Unfortunately, we have evidence to suggest that some of them went straight into the bin. I know that MSPs have been asked to visit their GPs' surgeries. If they have already done so, I ask them to check whether the surgery has the leaflet and whether it is displayed prominently. If not, I can give members some copies. If members have not already visited their GP's surgery, I ask them to come and speak to me.

There is a need to consider local protocols, local access to educational material and local patient information that is easy to understand. There is also a need to be proactive and to research early screening and the causes, prevention and treatment of DVT. We need to get the information out there and to listen to patients.

Each mainland health board received £40,000 for the prevention and treatment of Clostridium difficile, which is quite right—no one is going to argue with that. Apart from the leaflet that Lifeblood produced, I can find no evidence of specific funding for the prevention and treatment of DVT. Why?

After almost six years, Katie's family is waiting to be offered screening for thrombophilia. We must seek an effective prevention strategy and eliminate the failure of hospitals to diagnose effectively those patients who have potentially fatal DVT. Katie's family deserves an apology for what has happened. Money should be made available for further research into screening, and the public should be made aware of the existence of screening. That must be our aim for Katie.