IIDB

MouldyOldDough

https://forums.moneysavingexpert.com/discussion/comment/82141996#Comment_82141996

This is a good question - I have always assumed that I was responsible for my own demise by drinking but I requested SARS from all of the hospitals that dealt with me - and when putting them into context / wri8ting my memoirs - it became obvious that there were several anomolies - such as where were the records from the military hospital - and why was A&E not aware of the antabuse !

MouldyOldDough

I am pursuing an IIDB claim because I sustained a permanent acquired brain injury following two collapse episodes in 1990 that occurred after treatment with disulfiram (Antabuse) as part of an employment-related alcohol intervention programme.

The basis of my claim is not alcohol misuse itself. It concerns the medical events that followed treatment with Antabuse, the way those events were interpreted at the time, and the permanent neurological injury that resulted.

In May 1990, I suffered a sudden collapse, followed by a second collapse shortly afterwards. These events marked the onset of a severe neurological and metabolic crisis. Rather than being investigated primarily as a potential toxic, neurological or acquired brain injury event, the clinical focus appears to have remained centred on alcohol dependence and alcohol withdrawal.

A key issue is that the treating NHS clinicians were not provided with the full medical history relating to my recent Antabuse treatment. Because those records had not been forwarded from the MOD medical system, the doctors responsible for my emergency care were unaware that I had recently been prescribed and treated with disulfiram. As a result, a potentially important factor in the differential diagnosis was unavailable to the clinicians managing the collapsees.

The objective medical evidence recorded during admission demonstrates that the episodes involved considerably more than simple intoxication. The records document acute renal impairment, severe electrolyte abnormalities, metabolic acidosis, markedly abnormal liver enzyme results, and treatment with medications used in the management of serious neurological and withdrawal-related complications. These findings indicate a major acute physiological event.

Following the collapsees, I was left with bilateral pallidal necrosis involving the basal ganglia, a recognised structural brain injury. The long-term consequences included permanent impairment of speech, gait, coordination, handwriting and cognition. These deficits ultimately led to medical discharge, occupational restrictions and the loss of my previous operational engineering career.

My contention is that the two collapse episodes were the critical injurious events that caused the brain injury. The sequence of events was: treatment with disulfiram, subsequent collapses and acute metabolic disturbance, followed by documented bilateral basal ganglia damage and lifelong neurological disability.

The reason I am claiming IIDB is therefore that I suffered a permanent disabling brain injury arising from an employment-related chain of events. A central feature of the case is that the acute collapses were treated primarily as alcohol-related presentations at a time when the clinicians involved were unaware of my recent Antabuse treatment because the relevant medical records had not been provided. In my view, this contributed to the underlying neurological injury not being recognised when the collapses occurred.

HillStreetBlues

If I'm understanding this correctly as the MOD have "lost" your records they isn't anything stating you were administered Antabuse as far as written records are concerned?

MouldyOldDough

https://forums.moneysavingexpert.com/discussion/comment/82142958#Comment_82142958

very little - I do have records from the National hospital in london - mentioning it

teaselMay

I understand what you're saying but I think you'll find it very difficult to prove your case. The clinicians may not have known that you were on disulfram if you weren't able to tell them and they didn't have that part of your record, but they're likely to have considered it in their assessment of the situation given they were aware of an alcohol dependence issue as evidence by the clomethiazole prescription. Treatment of disulfram toxicity isn't with a specific antidote but is supportive, in all the same ways that you would have been treated in response to how you presented and your clinical signs.

peteuk

https://forums.moneysavingexpert.com/discussion/comment/82142958#Comment_82142958

30 odd years ago, hospitals were still hand writing notes and these were kept at the hospital, so even within NHS trusts you would potentially have more than one set of notes. As an example Naval hospitals in Portsmouth and Plymouth would have had a set of notes, with the larger NHS hospitals having a second set. These could have been merged at some point. These, as explained would be kept locally by the NHS.

OP - were you treated as an inpatient or outpatient. Either way your Gp would have been informed and a record of your treatment sent to them. Have you got access to these, or requested them from your current Gp?

I ask when was it prescribed and for how long did you take it, did you drink whilst taking it and at what point in the treatment did the collapses occur.

The use of the term medically discharged, along with “order to attend” sounds to me, you weren’t a civvy but in the Navy. Bearing in mind that the MOD lost crown immunity in 1987.

Unless you were taken to the same A+E as the hospital that treated your alcoholism, they wouldn’t have had any info on the prescription. Even today, the same applies, hospitals don’t have access to your other hospitals records or GP records.

I still say you need to prove that the collapse was due to the treatment, the rest is due to the collapse. Once you’ve proven that, then you will need to prove the NHS doctors were wrong but that this was because they were unaware of the prescription. The OP is correct in stating the signs and symptoms were more than simple intoxication, but even I could argue the majority of these would be caused by long term alcoholism (renal impairment, electrolyte abnormalities, metabolic acidosis, abnormal liver enzymes) Even if not drinking at the time, withdrawal can cause issues such as collapse/ LOC.

If “medically discharged” did you get a medical pension?

Newcad

I sympathise, however I have to go back to what I said before:

Unless the medication was prescribed in error, or was dispensed in error, then there is no "Industrial Accident" to be considered at all.

Yes, you appear to have suffered side effects, but side effects do not constitute an "accident".

Many medications and treatments may have unwanted side effects, but that is an "advese event" and not an accident.

unforeseen

I'm confused by the OP's expectation that military hospital records would have been passed to their GP or being available by other hospitals.

None of my medical records were automatically passed to my GP when I left the forces. The only way that my GP got the info was, after leaving the forces, requesting my medical records from MOD and physically passing them to my GP

peteuk

https://forums.moneysavingexpert.com/discussion/comment/82143441#Comment_82143441

You are correct the whole hospital records would have not been sent to the GP, but either a letter with the outcome of an outpatients appointment or discharge letter following in patient would have been sent to his GP at the time.

When Serving - your FMed 8 (GP records) has now been archived, if you were Serving when they brought in DMICP - digital medical notes, your FMed 8 would have been summarised onto DMICP. These would have been provided to your first Civvy GP upon request. Then as part of your GP records these would be passed between GP to GP if you move. Ironically the MOD provided my GP a print out of my summarised records and any consultations, which was then scanned onto my current GP records. Equally, due to an administration issue, when I moved whilst Serving, my Med Docs were sent to me, rather than the Medical Centre…so obviously I took them to the Med Centre and in no way have them. Honest!