"Dismissive doctor and missed diagnosis in A&E"

About: Good Hope Hospital / Accident & emergency

(as the patient),

I visited Good Hope A&E on an evening at the end of December 2014. I was accompanied by my sister and husband.

Upon arrival (approx 8:30pm) we were checked in quickly and waited around 40 minutes to be seen by a Doctor. The reason I visited A&E was due to an onset of severe facial pain, to my right side, along with neck & shoulder muscle tightness & cramps. My face had dropped and my eye lid tensed shut. I was very familiar with these systems, as in the November of 2013 I had experienced similar systems and was blue lighted to the A&E where I was diagnosed with Bells Palsy (left side).

Unfortunately I do not recall the name of the Doctor who was assigned to see me, but I’m sure this can be found from my medical records. On first impression the nurse who was accompanying, mentioned to my sister that she believed it was Bells Palsy. The Doctor quite rudely dismissed her judgement immediately and the nurse left the cubicle.

The doctor began to examine me asking me to stand up. Due to the tension in my muscles, my shoulder was cramped up against my chin. The doctor asked “why are you standing like that?” When I explained my symptoms, they began to pull my head off my shoulder and push my shoulder towards the floor causing me great pain. They continued to do this for a few minutes, repeating the phrase “relax will you”. Until I could not take anymore and burst into tears.

At this point my sister intervened as she could tell how much this was upsetting me. After a few minutes the Doctor asked if they could continue the examination, this time focusing on my eye. As it was cramped shut (same symptoms as my first episode of BP) the doctor again was very forceful, trying to pry my eye open, and again “asking why I was not opening it”. When I explained I hadn't any control over this, they said “it is not possible; the muscle is not strong enough”. This dismissive attitude towards anything I had to say was beginning to make me very distressed, at this point I asked my husband to take me home.

My Husband and sister refused to take me home until I had been examined properly. I continued to try and explain to the doctor the pains I was experiencing, as this was my main concern, and of my Bells Palsy episode in Nov 13. The response was “this is not Bells Palsy”.

When I explained I had experienced similar symptoms when previously diagnosed, they rudely confronted me again saying “Bells Palsy is not painful”. The doctor's manner was very offensive, I remember distinctly of the pains I had experienced, and could highlight that this was a similar thing. I asked the Doctor if they had experienced Bells Palsy, to which they ignored my comment and left the cubicle.

The nurse returned with some muscle relaxant medication, followed by the doctor who asked to take some blood tests. Once my blood had been taken, we waited nearly 4 hours for the results. By this time, my shoulder had relaxed, and eye was opening again. The pain was still very severe and by this time my hearing became very sensitive.

During the wait I could not believe the treatment the other patients were experiencing, one lady was on a bed in front of the nurses’ station, it turned out that she had been waiting 3 hours and had not even been registered as arrived. Another gentleman who had been referred by his GP as a suspected stroke, was left to sit in the waiting room for 2 hours, when he finally had enough and asked at the desk, was told that he had been assigned a bed on the ward and they thought he had already been taken up to it.

Eventually I had the same idea and asked at the desk to be discharged as I was unwilling to wait any longer for a Doctor who really didn't want to help me. The nurse at the desk recognised me from my first Bells Palsy episode and was asking how often I had onsets like I was experiencing. She advised my bloods test were ok and that I needed to see the Doctor who would discharge me. We waited a further 30 minutes. The Doctor confirmed the blood results and then went onto say they believed there was nothing wrong with me. I tried to ask the Doctor again about the pain I was experiencing for them to reply “If you feel you need to, then I would see your GP, but I don’t think there is anything of concern”.

The following morning, I visited my GP, who examined me fully, and listened to the symptoms I was experiencing. He prescribed me with the steroid prednisolone as he believed that it was early signs of Bells. I visited the Doctor again a few days later, as I was still experiencing severe face and neck pain, but no sign of facial changes. He asked me to continue the steroids and I was prescribed amitriptilyn for the pain, and hoped that nothing would develop further. Three days later, I experienced the familiar face droop and paralysis of Bells Palsy. I visited my doctor again who confirmed that it was indeed Bells Palsy. I have since been referred to a specialist and awaiting appointment.

My experience at Good Hope A&E was disappointing. The Doctor was unhelpful, rude and unsympathetic. After every effort from me and my family trying to explain about my history, the doctor was dismissive and aggressive. I feel that more could have been done. The steroids could have been prescribed from the A&E or even pain relief; instead I was misdiagnosed, dismissed and treated appallingly.

I would appreciate some feedback being passed onto this doctor as I would hope that it would prevent future patients feeling the way me and my family did when we left the A&E.

A response would also be greatly appreciated.

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Responses

Response from Richard Parker, Managing Director, Good Hope Hospital, Heart Of England NHS Foundation Trust

picture of Richard Parker

Dear Mrs Smith

I'm so sorry to read about your recent experience in the A&E department. If you would like to contact me directly I will take further details & address this directly with the staff concerned.

Best wishes

Richard

richard.parker@heartofengland.nhs.uk

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Response from Arne Rose, Consultant, Associate Medical Director for Good Hope Hospital , Management, Heart of England Foundation Trust

Dear Mrs Smith,

I am sorry to hear about your recent visit to A&E. I hope the Bell's Palsy is on the mend?

I am an A&E consultant by background, so if there is anything I can do to help clear this complaint up, please be in touch, I am willing to help.

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