Delay in diagnosing advanced cancer
Mr C had a previously suffered a stroke, causing a left sided weakness, in October 1999. He was able to walk around at home, and used an electric chair outside. He had carers in the morning and evening to assist him with dressing, but otherwise managed with the care and support of his wife, who also suffers from disabilities.
In October 2003, Mr C started to complain of pain in his left leg.
The GP was called in on a number of occasions and prescribed various treatments, from those for gout to antibiotics. None of these helped.
In the early hours of 22 December 2003 , Mr C woke in a significant amount of pain. His wife noticed that his leg was twisted inwards and she could not put it back in place. He was taken to Leicester Royal Infirmary by ambulance.
Mr C was seen in the Accident & Emergency Department where both he and his family confirmed that there had been no history of trauma or falls. The A&E doctor's initial diagnosis was that this was muscular pain and he had been intending to discharge Mr C. However, on his son's insistence, he was x-rayed. The x-ray was delayed for about 5 or 6 hours from the time that Mr C was first admitted.
The x-ray showed a fractured neck of femur and that night he had a hip replacement. Bone samples from the broken hip were sent to pathology.
This settled his pain significantly and, following four or five weeks rehabilitation, he was discharged.
About one week after his discharge, Mr C started to suffer from pain on the right hand side of his ribcage. Again, the GP was called and, in the absence of information from the Trust, diagnosed muscular pain or a stroke. He also tried prescribing antibiotics which were not helpful.
Mr C's condition continued to deteriorate and the pain got much worse. It kept him awake at night. Mr C started to withdraw because of the pain. He no longer wanted to go out and he became depressed. His son remembers him crying from the pain, although he had never seen his father cry before, even following the stroke.
His appetite was poor, although his family did not notice that he was losing weight.
Mr C's son described his father as a man of great presence and willpower, but also described how he changed and was worn down by his suffering.
In March 2004, Mr C was admitted to Leicester Royal Infirmary for 3 days for tests. He was discharged with a clean bill of health, and prescribed co-codamol for the pain.
This did not control the pain and Mr C continued to deteriorate. He was sent to the Leicester Royal Infirmary in May by his GP again. A chest x-ray noted a shadow on the lung.
Mr C was transferred to the respiratory ward at Glenfield Hospital . They requested his earlier notes from December and based on that, concluded that Mr C was suffering from prostate cancer. He was referred back to Leicester Royal Infirmary, Oncology Department where he was given a course of palliative radiotherapy.
By this point Mr C and his family had lost faith in the Leicester Royal Infirmary. He went to see Professor Nick James, a prostate specialist at The Priory and the Queen Elizabeth Hospital , Birmingham on a private basis. After seeing Mr C, Professor James offered to treat him as an NHS patient. He was transferred to Birmingham where he was started on Zoladex and given further pain relief, which helped.
Professor James called for Mr C's earlier records and, in these records, discovered a report dated 22 December 2003 confirming that samples of bone taken at the time of the hip replacement operation showed infiltration with poorly differentiated carcinoma.
Professor James informed the family of the diagnosis, and the delay in bringing it to their attention. However, he said that hormone treatment continued to have a good success rate.
Mr C was discharged home and was managing reasonably well until the beginning of July. At that point he began to have more problems breathing. He was admitted to Glenfield Hospital again, to a respiratory ward on Monday, 12 July 2004 .
On Wednesday, 14 July 2004 , Mr C's son received a telephone call from the consultant, Dr Khan, to say that things were not looking good. Mr C's son was told that the end would come `sooner rather than later'.
The next day, Mr C appeared better and was able to chat and joke with his family. On Friday, 16 July 2004 , Mr C deteriorated further and stopped taking medication. The family went into see Mr C who spent a couple of hours speaking to them and making his peace. Sadly, Mr C died on Saturday, 17 July 2004 .
The family made a complaint about the treatment that Mr C received. The Trust very openly acknowledged that the pathology results showing that Mr C was suffering from carcinoma in December 2003 were filed without being seen by a doctor. The results were not picked up during his in-patient stay in March either.
The family approached Bolt Burdon Kemp with the complaints correspondence. We were able to negotiate a settlement of £15,000.00 for them, for Mr C's pain and suffering for 7 months, within 5 months of first receiving instructions. It was agreed between the parties that, by the time Mr C's cancer had been diagnosed it had already spread and so he was unlikely to have been cured.
The Trust were very helpful to the family. They dealt with the matter swiftly and also offered a full apology and a meeting with a family, so that they could be reassured that lessons had been learnt.