Decision Report 201301491

Summary

Mrs C's husband (Mr C) was referred to hospital by his medical practice because he was suffering from fatigue and shortness of breath on exertion. He had some tests, but it was not until almost five months later that he was diagnosed with lung cancer. Mr C died shortly after the cancer was diagnosed. Mrs C said that her husband had a complicated medical history, but she was concerned that there appeared to be a lack of urgency by the hospital in establishing the cause of his symptoms.

To investigate the complaint, we carefully considered all the relevant documentation, including the complaints correspondence and Mr C's medical records. We also took advice from one of our medical advisers, who is a consultant in respiratory medicine.

We upheld Mrs C's complaint. Our investigation found that there was a three week delay before Mr C was seen at the respiratory clinic and, later, it took four weeks for the GP specialist's urgent referral request to be seen by the hospital's consultant respiratory consultant, although the reasons for this could not be established. After Mr C was seen, there was then little urgency in dealing with him. Our adviser confirmed that although an earlier appointment would have led to an earlier diagnosis, the outcome for Mr C would not have been different. However, Mr C would have had more time for palliative care (care to prevent or relieve suffering), which would have alleviated his pain and discomfort.

Recommendations

We recommended that the board:

• make a formal apology to Mrs C for the delay and lack of urgency; and
• ensure that, where cancer is suspected, there is a robust cancer pathway in place in accordance with the Scottish referral guidelines for suspected cancers.