Chamber
Plenary, 01 Oct 2008
01 Oct 2008 · S3 · Plenary
Item of business
Action on Thrombosis
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.
"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.
In the same item of business
The Deputy Presiding Officer (Alasdair Morgan):
SNP
The final item of business today is a members' business debate on motion S3M-2482, in the name of Trish Godman, on action on thrombosis. The debate will be c...
Motion debated,
That the Parliament notes with concern that, according to provisional figures from the Scottish Government, the total number of deaths from thrombosis in 200...
Trish Godman (West Renfrewshire) (Lab):
Lab
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....
Ian McKee (Lothians) (SNP):
SNP
I congratulate Trish Godman on initiating this important members' debate, and I join her in extending my condolences to Katie McPherson's family. We need to ...
Trish Godman:
Lab
I hear what the member is saying, but because there are so many questions about DVT—he is asking them himself—we need money so that we can research whether t...
Ian McKee:
SNP
I agree that research should be done, and that not enough has been done into the causes of DVT and its treatment. However, I still hold that it is wrong to e...
Jackson Carlaw (West of Scotland) (Con):
Con
Once again, Trish Godman has brought to members' business an important and substantial issue. Seven months ago, the issue was the human rights of wheelchair ...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
I add my congratulations to those of other members on Trish Godman securing this debate and on the way in which she graphically illustrated the tragic early ...
Margaret Curran (Glasgow Baillieston) (Lab):
Lab
I, too, thank Trish Godman for securing tonight's debate. As others have acknowledged, she has made a significant contribution to raising awareness of thromb...
The Minister for Public Health (Shona Robison):
SNP
I add my thanks to Trish Godman for securing a debate on this important but complex issue. Her motion mentions the death of Katie McPherson, and the first th...
Ian McKee:
SNP
Does the minister not agree that cigarette smoking is also a lifestyle choice that leads to an increased risk of DVT?
Shona Robison:
SNP
Yes, of course. I will say a bit more about that.The other risks for DVT include pregnancy, age, underlying cancer, being on the pill or hormone replacement ...
Trish Godman:
Lab
You are saying that screening would be done in some circumstances. It seems to me that Katie McPherson's family should have some support and screening, but t...
Shona Robison:
SNP
I am just about to deal with that issue. We agree that high-risk groups should be tested, and we are clear that the adult relatives of someone with factor V ...
Meeting closed at 17:35.