Decision Report 201303206

Summary

Mrs C complained that a consultant at Forth Valley Royal Hospital dismissed an urgent referral from her GP for suspected lung cancer and failed to follow up the suspicion of lung cancer. Mrs C said that the consultant failed to take account of her medical history or a recent x-ray and that, as a result, diagnosis of and treatment for lung cancer were delayed.

Mrs C's GP referred her to the respiratory unit because she had a longstanding persistent cough. The consultant there reviewed the referral letter, and as he thought it unlikely that she had lung cancer he decided not to see her at his clinic. He suggested that she first stop taking medication that was known to cause coughs, to see whether this was the cause of her symptoms. After taking independent advice from one of our medical advisers, although we found it acceptable for referrals to be screened in this way we found that the consultant overlooked information in the referral about Mrs C's recent x-ray. Whilst we were satisfied that the advice to alter Mrs C's medication would have been the same had the information about the x-ray been taken into account, we upheld the complaint about the consultant's actions and criticised the board, as this was a key item of information and it was clearly overlooked.

We did not uphold the complaint about delay as we were satisfied that although there was some delay in diagnosis, this was not unreasonable in the circumstances. We did, however, uphold Mrs C's complaint about the board's complaints handling as we found that their investigation and response were not thorough enough.

Recommendations

We recommended that the board:

• apologise for failing to note that Mrs C had had a clear chest x-ray;
• draw our findings to the consultant's attention; and
• review their complaints handling procedures to ensure that detailed, impartial, investigations are carried out into issues raised by patients.