Steroid Overdose - Negligent Drug Treatment

Belinda, 37 years old, Oldham

Belinda was referred by her GP to a neurologist at her local hospital because of a 6 month history of weakness in the legs, disturbance of balance and nystagmus.

The Neurologist wrote to the GP to advise that he feared that Belinda was suffering from multiple sclerosis (MS) and that he would admit her for further investigations including an MRI scan which was planned but never took place. The diagnosis of MS was not confirmed and she was discharged with arrangements for follow up in 5 months.

Shortly after discharge another GP at the practice visited Belinda at home and told her that she had MS. He prescribed the steroid ACTH to be given by intramuscular (IM) injection, and Belinda continued to receive this for thirteen years.

Two years after her first referral to the neurologists Belinda was referred to neurologists at a larger regional hospital. Belinda claims that she was not informed of this referral and did not receive any appointment letters from the hospital. Consequently she missed 2 appointments at the neurology clinic and therefore no further appointments were sent. Her GP was informed of this but he took no action until 3 years later when he referred her again.

By this stage Belinda had put on 6 stones in weight, was hypertensive and suffered from general fatigue, unsteadiness and immobility, all side effects of ACTH. At the neurology clinic she was seen by the registrar who could find no signs of multiple sclerosis. He did not inform Belinda of this or explain to her that most of her symptoms were due to the steroids she had been taking for the past 5years.

He wrote to the GP advising him of his findings and suggesting that the ACTH should be gradually reduced, but he made no arrangements to supervise the reduction. Despite the advice from the neurologist the GP continued to prescribe ACTH and it was not until  his practice was taken over by another doctor that any effective steps were taken to wean Belinda off the ACTH. 

Belinda never had MS and was probably suffering from a self limiting episode of demyelination. It is likely that she would have spontaneously fully recovered after a number of months had it not been for the prescribing of ACTH.

The ACTH caused Belinda to develop Cushing's syndrome. She became wheel chair bound because of excessive weight gain and was unable to work or to care for her family. She developed rheumatoid complaints and hypertension and became very irritable.

Despite stopping the ACTH Belinda has remained overweight and hypertensive. She has become angry and depressed since realising that her years of illness and poor quality of life could have been avoided had she not received such a poor standard of care.

Belinda is unlikely to ever fully recover from the effects of chronic over administration of ACTH. She is at an increased risk of stroke and heart attack and her life expectancy is reduced. Belinda received £100,000 compensation.