Delay in diagnosis of Cancer case reaches £420,000 settlement - written by Freya Johnson, Trainee Solicitor
Settled on 26 April 2022 at a Joint Settlement Meeting.
David Haines, Counsel, instructed by Clear Law Solicitors for the Claimant
Nicola Campbell-Clause, Counsel, instructed by NHS Resolution for the Defendant
Background
The Claimant, aged 43 on behalf of her late husband, received £420,000 as a result of the Defendant’s delay in diagnosis of colon cancer resulting in a metastasis and a terminal diagnosis. The Claimants husband sadly passed away on the 23/11/2019.
Between 2002 and 2011 the Deceased suffered from significant anorectal symptoms.
In 2011 he complained of persistent diarrhoea and weight loss. On the 13/05/2011 he attended his GP complaining of mucus and fresh blood passing from his anus for the previous 2 days. He also complained of watery stools. On examination he was diagnosed with a small fissure, he was given advice.
On the 20/05/2011 he had a further appointment. He complained of ongoing watery stools and had lost 1 stone in weight over the preceding 12 months. His weight was not recorded. The plan was to take a blood test and stool sample.
On the 01/11/2012 he attended his GP complaining of piles. It was noted that he was getting relief from using Anusol. No change is bowel habit was recorded. He was told to return in 1 week but there are no details of a further appointment.
On the 24/12/2012 he complained to his GP of swelling and pain in his groin. He was referred for a hernia repair.
In 2013 he was due to undergo hernia surgery. On 11/02/2013 he complained to his GP, Dr Haysom, of rectal bleeding. He was advised to discuss this with his surgeon prior to surgery. There is no record of any discussion with his surgeon prior to surgery and Dr Haysom did not call him back for review following surgery. It is not recorded that the Deceased was instructed to return in the event that he did not discuss his symptoms with the surgeon.
On the 25/02/2013 he underwent hernia repair.
On 23/12/2013 he was seen by his GP, Dr Shamim in respect of blood in his stools which was considered to be a consequence of piles. Whilst there was a clear history in the medical records of intermittent bleeding Dr Shamim did not address this. The main focus of the appointment was testicular pain.
On 27/10/2014 he was seen by his GP, Dr Duddy, complaining of further rectal bleeding and abdominal pain which had been recurring for more than 3 months. The history taken suggested that there had been no persistent change in bowel habit at that time. The Deceased was diagnosed with IBS and diverticulitis. He was treated for psychological symptoms and was prescribed with anti depressants.
The Deceased was referred to NHS colorectal surgeons in January 2015 having been complaining of persistent rectal bleeding for in excess of 6 months. Rectal examination was declined on account of pain. On the 02/02/2015 a routine NHS referral for colonoscopy was made and on 06/02/2015 a fast track referral was made. However, the Deceased’s evidence was that he had no knowledge of this.
In the meantime he booked a private appointment and was referred to Mr Baig who saw him on 17/02/2015. His abdomen was examined however rectal examination was declined as a consequence of pain. He recorded a 7 week history of change in bowel habit as well as persistent rectal bleeding. He was offered a private colonoscopy but advised he was unable to pay for the same. He was advised that arrangements would be made for a colonoscopy. It is the Claimant’s evidence that this was due to take place on the NHS.
The Deceased chased both his GP and Mr Baig for a referral but the same was not received.
On 06/04/2015 he was seen by his GP, Dr Young. She noted that he was waiting for a colonoscopy but no attempts were made to expedite this. He was diagnosed with diverticulitis and advised to continue to wait for the colonoscopy. He saw his GP again on 08/06/2015 and 23/09/2015. Again, no attempts were made to expedite the colonoscopy.
The Deceased attended for a colonoscopy on 12/11/2015 but the same was cancelled due to anxiety. It was recorded that the colonoscopy was required under general anaesthetic but no action was taken to speed up the process.
On 10/02/2016 he underwent a colonoscopy under general anaesthetic and rectal cancer was diagnosed following which invasive adenocarcinoma was diagnosed. The Deceased underwent 18 cycles of chemotherapy. In March 2017 lung metastases were diagnosed and the Deceased received treatment. His condition significantly deteriorated and his life expectancy was reduced.
The Deceased had 2 minor children and sadly later passed away on the 23/11/2019.
Liability
The Defendants owed a duty of care to the Deceased in relation to his treatment.
The Claimant alleged that:
- a) the tumour was high in the rectum at the recto-sigmoid junction. This area cannot be felt by the examining finger and thus the inability of the Deceased to tolerate a digital rectal examination has had no impact on the time of diagnosis.
- b) The NICE Guidelines advise any patient between aged 40 and older that reporting rectal bleeding with a change in bowel habit towards looser stools requires an urgent two week suspected cancer referral.
- c) Change in Bowel habit must be recognised and that while fresh bright red blood usually comes from low done, blood mixed in comes from higher up the gastrointestinal tract. Under examination it states that a digital rectal examination is usually appropriate, and proctoscopy and sigmoidoscopy should be used to identify anorectal sources of bleeding.
- d) The Deceased rectal bleeding could not be due to his inguinal hernia
- e) Mr Baig should have ensured that the coloscopy was carried out either by the end of Feb 2015 or at the very latest by the end of March 2015.
- f) There was likely a very small early tumour present in April 2013. There was unlikely to be metastatic spread from the tumour until after about March 2014. Surgery before July 2015 would have likely avoided a permanent stoma and pre-operative radiotherapy.
- g) the cause of highly likely to be metastatic colorectal carcinoma.
The Defendants initially denied liability in full, but, subsequently, admitted a failure to consider the Deceased’s previous history of rectal bleeding and it was inappropriate to make the diagnosis of diverticulitis. However, all other allegations were denied in full.
In a joint settlement meeting the Defendants accepted the Claimant’s counter offer of £420,000.00 where it was accepted but for the admitted negligence an earlier diagnosis would have been made which would have resulted in earlier curative treatment.
Injuries
By reasons of the death of the Deceased, the Clamant was bereaved and suffered serious financial loss and damage. The Deceased’s children also suffered psychologically.
An Infant Approval Hearing is taking place this month in order for the Courts to finalise the monies for the Children of the Deceased.
If you or a family member feel that you have suffered a delay in diagnosis of cancer or any other injury then please do not hesitate to contact the team.
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