Unfortunately, our patient’s ear doesn’t improve. In fact, the discharge continues to flow and the pain continues to progressively get worse.
On presentation again with our pharmacist, the patient is referred to their GP. The GP makes an urgent referral to secondary care. In the hospital, the patient is seen by the consultant who finds that the most likely reason for the continuing increasing hearing loss is ototoxicity and moreover it was down to the Sofradex that was prescribed. Sofradex is contra-indicated in patients with an existing ear perforation due to increased risk of ototoxicity.
On initial presentation, you may remember that our pharmacist chose not to look in the affected ear. Instead, she chose to prescribe Sofradex without examination of the ear. Furthermore, if she had access to the records she would have seen that this patient is particularly susceptible to ear perforations and in fact has had two previous perforations in the affected ear.
Do you think access to the patient record would have helped prevent this?
Do you think our pharmacist’s ‘self-certification’ of competence contributed to this significant event?
Would medical supervision of the prescriber have prevented this significant event?
Has our PIP been negligent?