Psychiatric medication negligence reports
An independent psychiatric opinion on the prescribing, monitoring and stopping of psychiatric medication, and on the psychiatric harm said to have followed, for claimant, defendant and single joint expert instructions. Free initial screening call and fixed fees with no hidden charges.
- Section 12(2) approved
- Claimant, defendant and SJE
- Structured for CPR Part 35
Prescribing, monitoring and withdrawal
Claims about psychiatric medication usually concern inappropriate prescribing, missed monitoring, adverse reactions that went unrecognised, badly managed withdrawal or toxicity. Dr Pradhan assesses whether the prescribing and monitoring of psychiatric medication met the standard of reasonable practice at the time, and what psychiatric harm followed.
The report sets the prescribing history against the records: the indication, the dose and its changes, the monitoring that was required and done, the warnings given to the patient, and the response to side effects or changes in mental state. It then addresses causation, separating the effects of the medication from the course of the underlying illness.
Dr Pradhan is section 12(2) approved and dual-accredited for claimant and defendant work.
What the report covers
Psychiatric medication reports commonly address:
- Whether the medication and dose were appropriate for the diagnosis
- Lithium monitoring, toxicity and its psychiatric consequences
- Clozapine and the monitoring it requires
- Valproate and the restrictions for women who could become pregnant
- Antidepressant discontinuation and withdrawal
- Benzodiazepine dependence and withdrawal
- Serotonin syndrome and neuroleptic malignant syndrome
- Interactions with other medicines
- Information given to the patient about risks and alternatives
- Review of long-term medication
- The psychiatric harm caused, and the course of the underlying illness
- Joint statements, supplementary questions and second opinions
Send a short note of the medicines involved, the allegations and the relevant dates, and Dr Pradhan will say whether the issues fall within her expertise and, if they do, confirm a fixed fee.
Submit an enquiryThe questions a medication claim turns on
The report deals with each of these, judged by the practice and information available at the time:
- Was the prescribing, monitoring or stopping of the medication reasonable?
- If not, what harm did it cause, as distinct from the underlying illness?
- What treatment is now needed, and what is the prognosis?
Where the harm includes physical damage, such as kidney or thyroid effects of lithium, the physical injury is for the relevant medical expert; the report covers the psychiatric side.
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Psychiatric prescribing and prescribing by others
Psychiatric medication is often started by a psychiatrist and continued by a GP. Dr Pradhan gives opinions on the standard of psychiatric prescribing and monitoring. Where the decisions in question were the GP’s, the standard is for a GP expert, and the psychiatric report can address the psychiatric aspects and the consequences.
Where pharmacological questions go beyond psychiatric practice, for example the detailed pharmacology of an interaction, the report says so and identifies the evidence needed.
Medicines commonly involved
- Lithium
- Clozapine
- Valproate
- Antidepressants
- Antipsychotics
- Benzodiazepines
Allegations commonly reviewed
- Wrong drug or dose
- Missed monitoring
- Abrupt withdrawal
- Unrecognised side effects
- Interactions
- Risks not explained
Prescribing guidance and the standard of care
The standard is judged by reasonable psychiatric practice at the time, with reference to the guidance then in force, including NICE guidance, safety alerts and the GMC’s guidance on prescribing. The report explains whether the care followed it and, where it did not, whether a responsible body of psychiatrists would have accepted the departure.
For claims in England and Wales the report is structured for CPR Part 35 and Practice Direction 35. Reports for proceedings in Scotland and Northern Ireland are prepared to the requirements of those courts.
The GMC expects prescribers to review medicines, monitor their effects and follow up patients appropriately. The report applies that expectation to the psychiatric care in your case.
Related pages
Medication questions
If your question is not answered here, call and Dr Pradhan will advise on scope and timescale.
Call 0121 752 6065Is an assessment of the claimant needed?
Usually, for the psychiatric harm and the prognosis. An opinion on the prescribing alone can often be given from the records.
Can the report separate the side effects from the illness itself?
That is one of its main tasks. The report compares the course of the illness with the timing of the medication changes and explains which effects are attributable to each.
The patient stopped an antidepressant suddenly. Is that within scope?
Yes. Discontinuation and withdrawal of antidepressants and benzodiazepines are commonly reviewed, including the advice the patient was given.
Does the report deal with physical harm such as kidney damage?
The physical injury is for the relevant medical expert. The report covers the prescribing and monitoring decisions and the psychiatric consequences.
How long does a medication report take?
It depends on the volume of records. The timescale is confirmed at the outset, once the prescribing history and the allegations have been seen.
Instruct Dr Pradhan on a medication claim
Send a short note of the medicines involved and the allegations, the funding route and any limitation or hearing dates.
- Phone0121 752 6065
- Emailinfo@
doctorpradhan.co.uk - Consulting Rooms NationwideAbacus Court, Harborne, Birmingham B17 0HH
Please do not include medical records or a detailed personal history in this form. Dr Pradhan will confirm how to send the papers once the instruction is agreed.
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If the matter is urgent, call 0121 752 6065.