UK Failure to Diagnose

In the UK, the failure to diagnose an injury or illness in a timely manner is one of the leading motives for making medical negligence compensation claims. However, not every compensation claim for the failure to diagnose is successful due to two factors – negligence and injury.

Failure to diagnose compensation claims have to show that “at the time and in the circumstances” a medical professional displayed a lack of skill that deviated from the accepted standard of care in the medical community. If it can be shown that another medical professional would have made the same misdiagnosis when presented with the facts of your case, a claim for the failure to diagnose may not be successful.

A failure to diagnose compensation claim also has to demonstrate that you suffered an avoidable injury or the significant deterioration in an existing condition. If, for example, a misdiagnosis or a late diagnosis would have resulted in the same outcome as if the correct diagnosis had been made, a claim for the failure to diagnose will not be successful. This is because although medical negligence has undoubtedly occurred, your health has not deteriorated any more than it would have as a result.

In order to establish negligence and injury, your solicitor would request access to your medical records and then have the records examined by an independent expert. If the expert concurs that the failure to diagnose resulted in an adverse event, then your solicitor will advise you on the process for making medical negligence compensation claims against the medical facility or individual responsible.

NHS Settles Medical Negligence Claim for Undiagnosed Deep Vein Thrombosis

An NHS Hospital Trust has settled a medical negligence claim for undiagnosed deep vein thrombosis that resulted in the death of a mother of three.

On March 15th 2010, Alison Taylor (29) gave birth to her third child, a daughter – Yvie-Mae. A few days later, she was referred to the Maternity Unit of Leicester Royal Infirmary by a community midwife after complaining of cramps and swelling in her right leg.

On her arrival at the hospital, Alison – herself a healthcare assistant at the Leicester Royal Infirmary – shared her concerns with staff that she might be suffering from a blot clot. However registrar Dr Vijay Kumar Kalathy discounted DVT as a diagnosis, failed to conduct a blood test, and told Alison he was unable to perform an ultrasound scan on her leg because it was the weekend.

Alison continued to suffer with the pain and swelling in her right leg, and attended her GP – Dr Philip Hussey – on 31st March. Dr Hussey also misdiagnosed Alison´s condition as cramp and prescribed her painkillers. Tragically, Alison was found collapsed later that evening by her husband, and died in hospital the same night due to a pulmonary embolism caused by deep vein thrombosis.

The inquest into Alison´s death recorded a narrative verdict, although Assistant Deputy Coroner Robert Chapman noted that a scan at the Leicester Royal Infirmary could possibly have saved her life. The University of Leicester NHS Hospitals Trust has since acted on the Assistant Deputy Coroner´s recommendations and re-introduce weekend scanning in its Maternity Unit.

Following the inquest, Alison´s husband – Darren Taylor made a medical negligence claim for undiagnosed deep vein thrombosis, alleging that Dr Kalathy had failed in his duty of care by not following hospital procedures when the possibility of deep vein thrombosis exists. The NHS Trust refused to accept liability for six years, but has now settled the medical negligence claim for undiagnosed deep vein thrombosis for a six-figure sum.

Speaking after his medical negligence claim for undiagnosed deep vein thrombosis had been resolved, Darren told his local paper: “ It has been a long, hard seven years but I am happy we have got the NHS to own up and the trust says lessons have been learnt. Alison was a healthcare assistant so she was very aware of the risks of DVT. But the doctors seemed quite dismissive of her symptoms. If they had done what they were supposed to do Alison should be here now.”

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Woman to Claim for Medical Negligence Resulting in a Preventable Amputation

A woman is making a claim for medical negligence resulting in a preventable amputation after doctors allegedly misinterpreted the results of a CT scan.

The unnamed woman was admitted to hospital in January last year after fracturing her left femur. As she had a clinical history of underlying malignancy, she underwent a CT scan, X-rays and a blood test to determine whether her injury was due to a disease – such as osteoporosis – that led to a weakness of the bone structure.

The test results were interpreted as showing no signs of a disease. The woman subsequently underwent femoral nailing surgery – a procedure in which a metal rod is inserted into the cavity of the bone to strengthen it – and she was discharged soon after. However, a bone sample taken during the surgery revealed the presence of a cancerous tumour.

The woman was readmitted to hospital the following month to be treated for deep vein thrombosis – a common complication of femoral nailing surgery – and, on her discharge, found that her discharge notification included the results of the bone sample test. She complained that nobody had told her about the presence of a cancerous tumour, and the hospital conducted an investigation.

The diagnosis of cancer was not confirmed until one week later and, due to the treatment options being compromised by the femoral nailing surgery, she had to undergo an above the knee amputation to prevent the disease from spreading. The hospital explained the reason for the cancer not being identified on the CT scan as the scan not including the site in the thigh where the tumour was located.

After seeking legal advice, the woman has instructed solicitors to investigate the level of care she received in order to see if she can justifiably make a claim for medical negligence resulting in a preventable amputation against the Central Manchester University Hospital NHS Foundation Trust. Her solicitor believes her claim for medical negligence resulting in a preventable amputation believes she may have a strong case. He said:

“The swift, and more importantly, accurate diagnosis of cancer is absolutely crucial as early treatment can often provide the best possible chances of recovery and to prevent long-term health complications. Sadly, in this case, the NHS’ own investigation suggests that the staff who treated the woman at the NHS Trust in question failed to carry out the correct tests, meaning her cancer was not diagnosed as early as it could have been.”

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Woman Settles her Claim for the Misdiagnosis of Skin Cancer

A woman who was told she had a malignant melanoma after being informed the growth was benign has settled her claim for the misdiagnosis of skin cancer.

In February 2013, Joyce Huck (72) from Sutton-in-Craven, North Yorkshire, underwent surgery at Bradford Royal Infirmary to have a growth on her skin removed. Two separate tests reported that the growth was non-cancerous but, when the growth started to develop again, Joyce expressed her concerns to her GP.

The GP referred Joyce for a biopsy and, on Christmas Eve 2014, she was called back into the hospital and told she had a malignant melanoma. Joyce underwent further surgery in early 2015 to have the growth removed again, and samples were taken from her lymph nodes to determine if the cancer had spread to her organs. Fortunately she was given the all clear.

After recovering from the second round of surgery, Joyce sought legal advice and made a claim for the misdiagnosis of skin cancer against the Bradford Teaching Hospitals NHS Foundation Trust – alleging that the stress and anxiety she had suffered between the correct diagnosis being made and receiving the all clear had been very painful for her and her family.

The NHS Trust admitted a breach in its duty of care, and a five-figure settlement of Joyce´s claim for the misdiagnosis of skin cancer was agreed. The NHS Trust also publicly apologised for the stress and anxiety Joyce and her family had suffered, saying it was “deeply sorry”. A spokesman added: “The care we provided fell below our usual high standards and we sincerely apologise to Mrs Huck for this”.

Speaking after her claim for the misdiagnosis of skin cancer had been resolved, Joyce told her local newspaper: “At the time [of being called back to the hospital] I was not told the previous biopsies had been misreported. It was only when I was referred to a plastic surgeon for the growth to be completely removed that I was told the earlier biopsies had also shown cancer. It was shocking to think I’d been living with cancer for so long and it had been left untreated.”

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Woman Awarded Compensation for the Failure to Diagnose Viral Encephalitis

A woman from Gloucestershire has been awarded compensation for the failure to diagnose viral encephalitis that led to her suffering permanent brain damage.

The unnamed woman attended her local hospital in June 2009 complaining of severe headaches and was kept in overnight for observation. Doctors sent her home the following day after failing to identify the symptoms of viral encephalitis – an inflammation of the brain – but she was re-admitted the following morning as an emergency.

Even though the condition was correctly diagnosed on her re-admission, the woman was not administered the correct drugs for forty-eight hours and her condition deteriorated – causing her to sustain permanent brain damage. She now needs around the clock care and suffers from acute amnesia – effectively living in a world of her own.

The woman´s family claimed compensation for the failure to diagnose viral encephalitis on her behalf. The Gloucestershire Hospitals NHS Foundation Trust admitted medical negligence and, at the High Court in London, the woman was awarded a £1.1 lump sum of compensation for the failure to diagnose viral encephalitis plus index-linked annual payments for the rest of her life.

At the hearing, Judge Sir Ian Dove commented: “Money can never fully correct what has happened to the claimant in this case, but unfortunately it is the best that the law can do. She will be now be comfortable and secure for the remainder of her life, will be able to stay in her own home and to have carers around her so that she can live the fullest life she can.”

Speaking on behalf of the Gloucester Hospitals NHS Foundation Trust, Barrister Alexander Hutton QC said: “We are extremely sorry for the failings that happened in relation to the care of this claimant. The consequences for her have been very grave. I would like to pay tribute to her family. They have been unstinting in their support of the claimant in very difficult circumstances. We do hope that this compensation helps and we do wish the claimant and her family all the best for the future.”

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Compensation for the Failure to Diagnose a Cancerous Mole Settled Out of Court

A woman has recovered a settlement of compensation for the failure to diagnose a cancerous mole after two doctors told her she had nothing to worry about.

The unnamed woman claimed compensation for the failure to diagnose a cancerous mole after attending her local surgery with concerns about a mole on her foot that had changed in appearance and become itchy. The GP she saw initially told her she had nothing to worry about and sent her home.

As the mole continued to concern the woman, she returned to the surgery a few weeks later. A second GP refused to refer her to a specialist and repeated the opinion that she had nothing to worry about before sending her home. Neither doctor measured the size of the mole.

It was only on a third visit to her local surgery that the woman´s concerns were taken seriously. The third GP she saw decided that she could not remove the mole but suggested cutting away the top of it. The woman declined the suggested treatment and was referred instead to her local hospital.

At the hospital, a dermatologist removed part of the mole and sent it for tests. The result of the biopsy was that the mole was cancerous, and the woman underwent an operation to have the entire mole removed. Unfortunately, subsequent tests revealed that the cancer from the mole had metastasised, and the woman is now undergoing treatment for secondary cancer.

The woman sought legal advice about her rights and, on the advice of her solicitor, claimed compensation for the failure to diagnose a cancerous mole against the GP who had first attended her and the surgery. She alleged in her claim that, had she received an appropriate standard of care on her first visit, the cancer would have been identified sooner and her prognosis better.

The GP and the surgery both denied negligence and contested that the woman was entitled to any compensation for the failure to diagnose a cancerous mole. However, after the defendants were threatened with court action, their insurance companies settled the claim for an undisclosed six-figure sum.

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Family Seeks Legal Advice about Claim for an Undiagnosed Neck Fracture

The family of a man who died after a compression of his spinal cord went unnoticed is seeking advice about making a claim for an undiagnosed neck fracture.

On 23rd May 2015, Patrick Byrne (87) was admitted to the Royal United Hospital in Bath following a fall at his home in Melksham. Shortly after his admission, Patrick´s neck dropped onto his chest and he was unable to move it.

Despite pleas from his family to investigate the issue, Patrick was discharged to the Chippenham Community Hospital in June. He was readmitted to the Royal United Hospital following a further fall, but it was not until 6th July that a scan was organised for Patrick´s neck.

The scan revealed that Patrick had fractured his neck in the fall at his home and the fracture had resulted in his spinal cord being compressed. The compression of the spinal cord caused Patrick´s paralysis from which he never recovered. Patrick sadly died at the Royal United Hospital on 21st October.

A two-day inquest into Patrick´s death at Avon Coroner´s Court returned a verdict of death by natural causes despite coroner Peter Harrowing stating that Patrick was let down by numerous medical staff who failed to carry out proper examinations or act quickly when serious signs were identified.

A catalogue of faults in Patrick´s care emerged during the inquest. Weekend staff shortages, speculative diagnostic suppositions, poor record keeping and basic deficiencies in communication were said to have communicated to Patrick´s death. However, Mr Harrowing found the hospital’s care did not reach the point of negligence as he believed the paralysis and his eventual death were not preventable.

Family Describes Coroner´s Verdict as Bizarre

Patrick´s family have described the coroner´s verdict as bizarre and have engaged medical negligence solicitors to investigate the possibility of making a claim for an undiagnosed neck fracture. Speaking after the inquest hearing, Patrick´s daughter Elizabeth told the Wiltshire Times:

“The standard of care my father received fell well below what should have been expected and, if the neck fracture had been diagnosed earlier, he could have had treatment which would have avoided the paralysis and his last months would not have been as distressing. The evidence was there. There were a lot of failures.”

The solicitor has said that he will be reviewing the coroner´s findings and reporting back to the family with regard to the practicality of making a claim for an undiagnosed neck fracture. A spokesperson on behalf of the Royal United Hospitals Bath NHS Foundation Trust said: “We would once again like to offer our deepest condolences to Mr Byrne’s family at this difficult time. We acknowledge that we did not always meet our own high standards of care on this occasion and for this we apologise.”

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Liability Admitted in Claim for A&E Medical Negligence

An NHS Trust has admitted liability in a claim for A&E medical negligence made by a woman permanently disabled due to a misdiagnosis of cauda equina syndrome.

On 2nd June 2011, Michelle Turner (41) woke up with intense sciatica pain in her legs. Her condition deteriorated throughout the day and – barely able to stand – she attended the Accident & Emergency department of the Royal Berkshire Hospital later that evening. Doctors at the A&E department failed to conduct a thorough investigation of Michelle´s condition, and sent her home with a prescription for the muscle relaxant diazepam.

Three days later, Michelle noticed that she had wet herself while out on a walk with her partner and four children. She phoned her GP, who recognised the symptoms of cauda equina syndrome – a serious condition caused by the compression of the nerves at the bottom of the spinal cord. The GP told Michelle to return to the A&E department, where she was admitted and underwent surgery the same day.

Despite the delay between initially attending the A&E department and undergoing surgery being just three days, Michelle is permanently disabled and incontinent. She can only walk with the support of crutches, and the condition has left Michelle “a former shadow of herself” and resulted in the breakup of a twelve-year relationship. In addition to her disability, she is on a pain management course to help her cope with day-to-day living.

After seeking legal advice, Michelle made a claim for A&E medical negligence – alleging that if the doctors in the A&E department had investigated her condition thoroughly, given her an MRI scan, a pin prick test or a rectal examination – all standard procedures for a suspected spinal condition – she would have undergone surgery sooner and not suffered such devastating consequences.

Following an investigation, the Royal Berkshire NHS Foundation Trust admitted liability and issued Michelle with an apology “deeply regretting” the standard of care she received. Michelle´s solicitors are now in negotiations with the NHS Trust to settle her claim for A&E medical negligence based on the long-term care and equipment she will need to cope with her disabilities.

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Widower Awarded Compensation for the Failure to Dispatch an Ambulance

A widower has been awarded an undisclosed settlement of compensation for the failure to dispatch an ambulance when his wife was complaining of chest pains.

On 28th December 2011, Ann Kinsey (68) returned to her home in Wolverhampton from her job at the local Waitrose supermarket complaining of chest pains. Ann´s husband, Brian, called NHS Direct (now replaced with the 111 non-emergency service) and received a call back from an out-of-hours GP. The GP advised Brian that Ann seemed to be suffering from either acid reflux or gastroenteritis.

The GP also told Brian to get Ann some antacids and pain relief tablets; but, when Brian returned from the pharmacy, he found Ann lying unresponsive on the floor. Brian immediately called 999 and, when paramedics arrived, they worked to resuscitate Ann for an hour before taking her to New Cross Hospital. At the hospital, an emergency team try to resuscitate Ann for a further thirty minutes, but without success.

Brian sought legal advice and claimed compensation for the failure to dispatch an ambulance when he first contacted NHS Direct. The NHS Direct Trust acknowledged that there had been a breach of duty in respect of the failure of the out-of-hours GP to provide the correct diagnosis and advice, but denied that dispatching an ambulance at the time and in the circumstances would have prevented Ann´s death.

On Brian´s behalf, medical negligence solicitors pursued his case, and now Brian has received an undisclosed settlement of compensation for the failure to dispatch an ambulance. Speaking to his local paper, Brian said:

“If an ambulance had been dispatched that night, it may not have stopped her going into cardiac arrest, but at least she would have been in the best possible hands and at least stood a chance of living. Nothing can bring Ann back, but it was very important to me that NHS Direct acknowledged its mistakes so that no one else would suffer as she did”.

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NHS Litigation Authority Settles Claim for the Missed Diagnosis of Cancer

A woman from Swindon has received £50,000 compensation from the NHS Litigation Authority in settlement of her claim for the missed diagnosis of cancer.

In March 2009, the unnamed mother of two attended her GP complaining of a lump on the left side of her neck and a persistent dry cough. The woman was referred to the Ear, Nose and Throat Department of the Royal United Hospital in Bath, where she underwent a CT scan.

The scan suggested that the woman may have cancer of the lymph nodes, but the biopsy sample taken to confirm the result of the CT scan was insufficient for a full assessment to be conducted. A review of the scan concluded that there was no need to conduct another biopsy and instead the hospital carried out an MRI scan on her neck.

Following the MRI scan, the woman was diagnosed with “idiopathic vocal chord palsy” – a weakness of the vocal chords that manifests in a persistent dry cough and a hoarse voice. However, in July 2011, the woman returned to her GP with an increase in size of her left cervical lymph nodes, and pins and needles in her left arm.

The GP sent his patient for an urgent chest X-ray and ultrasound scan of her neck. This time the woman was diagnosed with metastatic breast cancer that had spread into her neck and left shoulder and had to undergo six courses of chemotherapy. Fortunately the treatment managed to halt the spread of the cancer and the pins and needles disappeared.

Due to the distress she had experienced, the woman made a complaint to the Royal University Hospital. The hospital denied any failings in the standard of care she had received, so she sought legal advice and made a claim for the missed diagnosis of cancer after an investigation commissioned by her solicitor detected a number of abnormalities on the 2009 scan.

In her claim for the missed diagnosis of cancer it was alleged that, if the cancer had been correctly identified in 2009, the disease could have been treated with hormone therapy and the woman would not have required chemotherapy. It was also alleged that the appropriate treatment in a timely manner would have cured the vocal chord palsy from which she still suffers.

The Royal United Hospital continued to deny its liability for the woman´s experience but, after issuing court proceedings, her solicitor was able to negotiate a £50,000 settlement of the claim for the missed diagnosis of cancer with the NHS Litigation Authority. Speaking after the claim for the missed diagnosis of cancer had been settled, the woman´s solicitor said:

“Despite our client’s experience, the defendant continued to deny that the failure of the radiologist to report the abnormalities in the MRI scan fell below an acceptable standard of care. This is disappointing but sadly, has become par for the course in clinical negligence cases, where the NHS Litigation Authority and its defendant solicitors refuse point blank to accept liability. However, we are delighted that we achieved a very good settlement for our client”.

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Increase in Claims against Primary Care Nurses for Medical Negligence

The Medical Defence Union (MDU) has reported a steep rise in claims against primary care nurses for medical negligence over the past decade.

The MDU is one of the largest organisations providing medical practitioners in the UK with insurance against medical negligence claims. In 2005, the organisation recorded just two claims against primary care nurses for medical negligence. In 2015, that number had risen to twenty-five.

Much of the increase is attributed to the changing role of primary care nurses in the past decade. An analysis of the claims against primary care nurses for medical negligence shows that nurses are seeing patients with more acute conditions – patients who historically would have been seen by a GP.

The report by the MDU mirrors one produced in 2012 by the Medical Protection Society that attributed the increase in claims against primary care nurses for medical negligence to an expansion of the nursing role and a greater awareness of patients´ rights.

The figures produced by the Medical Protection Society showed the majority of claims against primary care nurses for medical negligence related to missed diagnoses, while the second most common cause was a failure to properly manage chronic diseases such as diabetes, asthma, coronary heart disease and hypertension. Three contributing factors were identified by both organisations:

  • The failure to refer (or a delaying in referring) a patient to a GP or specialist.
  • An inadequate assessment of a patient´s condition.
  • Inadequate monitoring of how a disease is progressing.

The MDU´s medico-legal advisor – Dr Beverley Ward – said: “Many practices have devolved more responsibility to nurse practitioners in their team to cope with the increasing demand. However, in taking on roles such as assessing and diagnosing patients, prescribing medicines, and running minor injury clinics, nurse practitioners are also at an increased risk of patients holding them individually accountable if something goes wrong.”

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