"Failure to diagnose cancer"

About: Queen's Hospital / Medical oncology Queen's Hospital / Neurology

(as a relative),

My father had a major seizure in 2013 that the local A&E insisted was a diabetic hypo. He was referred for an urgent brain scan by our GP: the local hospital initially failed to act on the referral claiming not to have received it, then made an appointment for 4 months later, finally reduced to 3 months later.

After the scan he was seen by Neurology that same month at the end of 2013, assessed and told he might have Dementia. Four months later in 2014 he was told by Neurology that nothing on his brain MRI suggested Dementia, that he had Epilepsy and so was put on increasing doses of Keppra. He had back pain and then also rib pain from the seizure in 2013 onwards which he reported each time he ended up in A&E due to seizures and on every visit to Neurology, but nothing was done about it until he was seen by a Diabetes / Endocrinology Consultant in July 2014 for a by now suspected Insulinoma (which the specialist told him was unlikely) and was sent for immediate back x-rays.

The results of those x-rays seemingly disappeared as our GP and others were told they couldn't be located when they tried to follow up on them, however, they are now in his file. My father was finally booked for an MRI mid-August 2014, after which he became mostly immobile and bedridden.

That MRI finally showed by then Stage 4 secondary cancer through his spine, ribs and liver, with a mass on one kidney and an extremely enlarged prostate - medical staff mentioned that his prostate had been removed in 2012, but there it was larger than life on a CT scan, his notes were incorrect. He died exactly seven weeks after being given the diagnosis, having been left in the care of Neurology instead of Oncology who simply told him because of his age (in his seventies) and state of health there was no longer a treatment option available.

The hospital forced the issue of dumping him in a nursing home on a Saturday morning, when admissions were only Monday to Friday, where he died 6 days later. For the 6 weeks he was on the Neurology ward at the end of his life we constantly had to explain to staff that he was dying from terminal cancer and wasn't just a whinger with a bit of backache.

We now have his medical records that show inaccuracies and staff believing he had Dementia during those last weeks of his life. My father endured suffering for months on end because of the local hospital constantly ignoring the pain he was in and that was with his family supporting him and pushing for help for him as well as querying whether it could be cancer and being told no.

It seemed as though Neurology had failed my father and Oncology did not want to get involved because of those mistakes. A senior member of nursing staff told another relative we were overreacting because the Neurology Consultant called us in for a meeting, and was stunned to be told my father was dying of cancer. The Ward Manager was mainly interested in discharging him and the Social Worker was told to apologise for approaching my father about going into a nursing home - he thought he had Dementia and was unaware that he was dying - but no apology was forthcoming.

Neurology did their best those last 6 weeks but they were not Oncologists. Nursing staff did not seem to understand the importance of keeping his pain levels under control, it seemed patient privacy - and perhaps an attempt to cover up the seriousness of what had gone wrong - led to a need to ask for pain relief for him on a number of occasions. Plus staff reluctance to work with certain colleagues led to patients not being seen when two staff were needed to help patients. And this is only a summary.

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Responses

Response from Barking, Havering and Redbridge University Hospitals NHS Trust

I am truly sorry for the poor experience you and your father had at our hospital, and would like to offer my condolences. Our Clinical Directors for Cancer and Neurology are keen to meet with you and your family so we can discuss this further and ensure that we learn from any mistakes. I’d be grateful if you could get in touch with me so that I can arrange this for you.

Wendy Matthews-Interim Chief Nurse