"Nobody Can Make a Decision // Lack of Urgency"

About: Princess Royal University Hospital (Orpington)

My Grandmother was admitted to the PRUH on the 08/05/14 following a chest infection, urine infection and suspected bleed on the brain. Due to the suspected bleed on her brain they decided on stopping her Warfarin temporarily which is used to keep the blood at a particular INR level (2.0 - 3.0) so that if she was to have an episode of Atrial Fibrillation she would not subsequently suffer a stroke. The doctors ordered a CT Head Scan but could not be certain as to whether there was a 'new' bleed on the brain or an existing one. When we suggested they compare the new scan result with my Grandmother's scan she had two years ago when admitted to the PRUH with a stroke they apparently could not find the scan which I find hard to believe. If the two scans were compared then surely the Doctors would know as to whether it was a new or existing bleed (not rocket science). Following discharge, a CT Head and MRI Head Scan as an outpatient was organised and we urgently await the results so Boots and her GP know whether she can re-commence Warfarin. All the time my Grandmother is without Warfarin she is at a high risk of having another stroke. We have been chasing and chasing the Consultant's Secretary for the results but to no avail. Because of the suspected bleed on her brain it is for this reason she is not currently allowed to take Warfarin; however that said all the time she is not taking Warfarin the risk of another stroke could easily occur. We have been advised by various Doctors (including the Respiratory Consultant) at the PRUH that it is a new bleed, no it's not, we can't be sure, it's only a small bleed, and the scans need to be sent to Kings College........ Nobody is able to give us a professional conclusive diagnosis and this is not good enough! Given the urgency regarding the continuation of Warfarin as mentioned above I can honestly say no urgency has been given at all, we are still none the wiser as to whether there is in fact a bleed on the brain, communication is poor and the whole saga has been a really slow, poor, unprofessional experience to the point we don't know what to believe and therefore have lost faith in this hospital!

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Response from Princess Royal University Hospital

I am saddened to read this posting dated 5 June as I have been actively trying to assist with this problem this week and some of the information in this posting seems outdated. The issue is also falsely titled cardiology but the actual issue relates to delay in a diagnosis and the witholding of medication which assists in the management of a cardiac condition.Dr Deborah Ramsey, Consultant in Stroke Medicine contacted the family on 2 June and offered advice on the current status of the warfarin and scan results. She has said that the scans will be further reviewed in the stroke medicine xray meeting on 9 June and GP, patient and family will then be contacted with a conclusion on the scan findings and ongoing warfarin management. I have advised that the medical management during the admission can be further investigated and have offered information on the best method of undertaking this. I myself continue to be available for ongoing discussion and assistance regarding the concerns raised. I am very sorry that there is further delay until Monday to resolve thsi matter but thought that the phone call on Monday had sought to explain the delay and the clinical reasons for it.

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