Wrong diagnosis led to three years of unnecessary steroids

What happened

Mrs M's GP referred her to the first Trust's rheumatology department in summer 2010 after she reported long–standing joint pain in her knees, hips and lower back. The GP's referral letter included recent blood test results that showed antibodies which can indicate lupus. This is a complex and poorly understood autoimmune condition that affects many parts of the body. The GP had not found any features of lupus and had therefore requested specialist input.

The first Trust arranged further investigations. Trust staff saw Mrs M relatively frequently over the next three years, during which time the first Trust continued to prescribe steroids for lupus. However, the first Trust's tests had borderline results that were open to interpretation.

While she was under the first Trust's care, Mrs M was also prescribed another medication that her GP stopped three months later because of abnormal liver test results. The first Trust acknowledged this was prescribed to her in error and was intended for another patient. It apologised for the mistake.

In summer 2013, Mrs M was still in pain so she asked her GP for a referral for a second opinion. She went to the second Trust in autumn 2013, and staff there diagnosed her with fibromyalgia (a long–term condition that causes widespread pain). The second Trust told Mrs M that there was no suggestion she had lupus and told her about steps she could take to improve her symptoms. Mrs M told us that her joint pain improved once she stopped taking the medication prescribed by the first Trust.

What we found

It was unreasonable for the first Trust to have diagnosed Mrs M with lupus because she did not have the clinical indicators for this condition. The medication the first Trust prescribed her for lupus was therefore unnecessary, although it was unlikely to have had any long–term impact.

We also found that the first Trust had already acknowledged prescribing a drug in error and we were satisfied with the actions it took to resolve this concern.

Putting it right

The Trust wrote to Mrs M to acknowledge its failing and apologise for it. It paid her £2,000 to recognise its misdiagnosis, failure to provide a correct diagnosis and lack of symptomatic relief in the three years that she was under its care.

The Trust drew up an action plan to show that it has taken steps to prevent similar failings happening again.