Decision Report 201205004

Summary

Mrs C complained about the care and treatment that her late husband (Mr C) received after an angiogram (a type of x-ray used to examine blood vessels) showed that he had two cerebral aneurysms (weak points in the blood vessels supplying blood to the brain, causing them to bulge or balloon out). Mr C's right leg had suddenly given way and he was unable to stand. He saw his GP two days later and was referred to a stroke clinic, where he was seen by a consultant the following day. The consultant found no evidence of any neurological problems and noted that Mr C's right thigh was tender, which would not be expected if a stroke had occurred. The consultant considered two other possible diagnoses: a drug side effect; or that the leg weakness related to back pain. However, he decided to request a scan of Mr C's head, given the history of vascular (circulatory) disease in his family.

The scan showed no evidence that Mr C had had a stroke or of what had caused the problems with his leg. It did, however, show a possible cerebral aneurysm. An angiogram was then carried out, which showed that Mr C had two cerebral aneurysms. The radiologist who interpreted the results suggested referral to a neurosurgical unit (dealing with surgery of the brain or other nerve tissue) but the consultant in the stroke clinic considered that the aneurysms were incidental and had not caused the problem with Mr C's leg. He arranged to see Mr and Mrs C to discuss the findings and then referred Mr C to a neurological unit for assessment. However, Mr C collapsed and died a few weeks later before attending the neurological unit.

We took independent advice on this case from two of our medical advisers - a GP and a neurosurgeon. We found that it was reasonable for the consultant in the stroke clinic to consider that the aneurysms had not caused the problems with Mr C's leg. We also found it reasonable that the consultant met Mr C before referring him to the neurological unit, and we noted that Mr C was referred to the unit two days after that meeting. As it was not considered that the aneurysms had caused the symptoms, an urgent referral was not necessary. We did not uphold the complaint as we did not find any failings on the part of the board.