Decision report 201202914

Summary

Mr C complained about the care and treatment of his late wife (Mrs C). Mrs C had developed a cough and, when it persisted, she visited her GP. She was given a range of medication over the next six weeks. When the cough did not clear up, the GP referred her for a chest x-ray, which was reported as normal, and she was referred to a respiratory consultant. While Mrs C awaited this appointment, her symptoms persisted and she developed a pain in her hip. She was given painkillers and referred for an x-ray of her pelvis. This was also reported as normal. When the pain continued and Mrs C also developed numbness in her shoulder, she was given an urgent referral to orthopaedic services. The hospital changed this to a normal referral. When this was identified, the GP changed the referral back to urgent. By this time, Mrs C had seen the respiratory consultant, who diagnosed her with a viral infection. When Mrs C had still not been seen by orthopaedic services a week later, her GP sent her to the hospital with an urgent referral. Mrs C was admitted, and was diagnosed with lung cancer.

Mr C complained that the medical practice failed to diagnose lung cancer for several months. Our investigation reviewed the NHS guidance on suspected cancer, and we took independent advice from one of our medical advisers. We did not, however, uphold Mr C's complaint. The advice we received was that the medical practice acted appropriately, based on the information they had. Mrs C was at low risk of lung cancer, and chest x-rays are the standard initial diagnostic tool. The lack of evidence of lung cancer was borne out by the chest physician's diagnosis of a viral infection. We also found that the medical practice referred Mrs C appropriately for x-rays and specialist opinion.