Need some MN legal brains/ clear thinking/ someone to point the way forward....please

[Dowser]

Ive put this here because it gets a lot of traffic but feel free to move.

So, deep breath, here we go.

I've got a cousin I'll call Ann and husband Jim.

Jim goes to the doctors in 2011 complaining of bleeding from rectum and stomach pain.

GP examines him , finds a haemorrhoid and treats him accordingly.
Jim makes several visits of this nature and each time is treated for 'piles'.

Never is he sent for or suggested he has a colonoscopy.

2012 this is still ongoing. It's where I come into the picture. We don't live near Ann and Jim but we get together for a family celebration,get on so well together that we start seeing each other four or five times in the year for a week at a time. So, I too become aware of his problems.

2013 Jim still having problems. On a couple of their other breaks away Jim ends up at a and e in pain. Even ends up in a and e at his locall hospital and still no red flag is waved.

Come sept 2013 a new doctor joins te practice as the other three are retiring. Jim sees this new doctor who is quite alarmed at what has gone on. Jim is sent for a colonoscopy.

And you know what is coming next....He is diagnosed stage 4 colorectal bowel cancer in feb 2014!

He has chemotherapy, radiotherapy. An operation to remove the tumour. He is left with a permanent stoma bag and 16 weeks of aggressive chemotherapy.

He never made the last chemotherapy. He was too sick, weak in too much pain for them to Administer it.

He was taken into hospital where he died three weeks later in march 2015.

Before his surgery in 2014 he was advised to see a solicitor about his misdiagnosis. I used to work for one of the big companies ( I'm not a solicitor ) and Juim took my advice and instructed this company.

This week Ann has had the heartbreaking news that they will not proceed with the case. They have employed an expert witness and in Jims notes there is no mention of bowel problems in a crucial 10 month period between early 2012 and 2013.

Excuse me if I'm a bit vague at this point because I dont have the notes in front of me.

The expert witness( an oncologist ) can only go on what's in front of him. He states in his report that the outcome of Jims illness would have been the same if he had had intervention 5 month earlier which I don't disagree with but what about earlier intervention in 2012. These are the notes that we just don't know about.

So, the solicitors won't proceed with the case..because of lack of evidence.

Obviously we need to see Jims notes. We also need to talk to the solicitors before they close the case in ten days time.

Just wondered if anyone has any experience of this. I'm out of my depth here but it just seems like Jim has been treated really shabbily and I want to do my best for Ann. It doesn't help being so far away. I just worry that if I start interfering without knowing what I'm doing I could make things worse.

I don't understand how the GPs have not documented Jims pain and bleeding in those crucial 10 months. Gawd, if I knew about it, the doctors certainly would. Jim was no shrinking violet. He would have complained vociferously to the doctors.

I think when the expert witness says you need to drop the case, then you need to drop it.

It is of course horrible and tragic and unfair what happened to him, but a legal case won't bring him back or make up for what happened. And I say this as someone who was told to stop wasting doctors time 3 times before getting a cancer diagnosis.

One of the natural stages of grieving is blame, and that is possibly what the family is going through now, but prolonging it by fighting a case with no evidence isn't going to help anyone in the long run.

I disagree. If he was treated earlier, he'd still be here. His family would presumably be better off financially as well, of course, as the most important factor of having him with them.

Everything changes when the major earner dies - he needn't have died if someone had treated him seriously.

What has happened to his records when he first went to complain, OP? Are they missing?

Does Ann know he saw the doctor about this during the relevant period and does she have evidence, e.g. diary entries for appointments, prescriptions etc? If he had prescriptions, can she check with the chemist?

But I agree that I would counsel caution about this. If Ann and you are upset about this news now, you would be considerably more upset if you went through the enormous strain involved in a full-blown trial only to lose at that stage.

No guarantees that earlier treatment would have saved him.

No guarantee that earlier treatment wouldn't have saved him either.

What a horrible situation, but perhaps this needs parking for a while. I think you have up to 4 years to bring a claim and more evidence may become apparent in due course.

I'm sorry for your loss. You have no way of knowing when the original problem became malignant, it could have been very recent. You have no way of knowing if earlier treatment would have made any difference. You have an expert witness informing you that there is no evidence to proceed with.

it is a terrible thing that has happened, but it was not necessarily down to any misdiagnosis at the time, and there is no evidence that it was, so nowhere to go with this, sorry.

I think if it's an independent expert witness then you will have to trust in his judgement i.e. There is no evidence of wrong-doing.

Also remember that people behave differently in front of a GP. Jim might have down-played his symptoms to the GP. I think it's quite normal for people to have bleeding and stomach pains due to piles. It isn't always a sign of cancer.

I don't know. There's so much to find out and of course Ann is grieving and upset so not always thinking clearly. I don't want to keep probing and ferreting away at her.

It's true what you say. He brought the money into the house and now in mid 50s she's left in straightened circumstances and someone did speak about this claim being in the region of £2 million. Who that was I don't know.

I feel if we don't say or do something now ( you only have 3 years ) we could regret it later.

Questions I'd love to know the answer too is why didn't the GP send him for a colonoscopy after the third or so visit.

Why when he turned up at a and e on holiday was he not referred to a specialist . No one goes to a and e on holiday unless they've had a traumatic injury a bad slip or trip or something that is so painful that it just can't wait until they get home.

Honestly my mind is reeling but I don't want to go wading in unless I have all the facts.

We need to reply to the solicitor in the next ten days. That's action one

Action two I think is to get a copy of the medical notes

I know earlier intervention might not have resulted in a cure but it might have given him more time and maybe a bit more time

Whoops posted too quick

And a bit more time to live well. He got a few months after first chemo and radio before the op. then after the op a few more months. By November last year it was downhill all the way.

It's three years to bring a claim, beginning at the date when Jim knew or should have known about the possibility of negligence. So the limitation date is probably February 2017.

You say he was diagnosed with piles, but then that he had a misdiagnosis. As another poster said, if he went in to the GP, downplayed his symptoms and the doctor found a hemorrhoid, he hasn't been misdiagnosed.

People suffer with hemorrhoids for years with it being nothing untoward so I'm not sure if that in itself would be an automatic cause for a referral to a colonoscopy.

If he had been going in with symptoms repeatedly, the doctor couldn't find anything wrong but told him it was probably IBS, well that would be a misdiagnosis, surely?
And the A&E visit - unless he said 'I've been seeing my doctor about this for years', then the hospital wouldn't know the history. They don't have access to his doctors notes.

If Anne is struggling (and why wouldn't she be under the circumstances), I'm not sure dangling the carrot of £2m in front of her if she will help you with a huge admin job is a very wise move. Presumably he had a life insurance plan, or death in service cover through work, so perhaps a better use of your time would be helping ensure all those are claimed properly and his pension is properly transferred?

Can't you (his wife) decide not proceed at the moment, and then instruct at another time (within the 3 year timeframe) though? It seems unlikely you'll get anywhere with anything in 10 days tbf.

You sound like a lovely friend to Anne Op, but I agree with sparechange. Perhaps at this time your efforts would be better focused on supporting Anne with other insurance plans/pensions etc.

The ten days is just to ask the solicitor not to close the case.

No life insurance. Something to do with it not being reinstated when mortgage was paid off last year.

Not sure about pension. He was only 55 and hadn't worked for a few years owing to other health problems

A diary of appointments would have been extremely useful but I don't think there is one. Pretty sure there won't be.

I just wish this figure of £2 million hadnt been bandied about . It gave the impression it was going to be a foregone conclusion which as most of us know never, ever is.

But thanks for your stories and help because this just feels like one big muddle at the moment .

You need a copy of his notes and then make a chronology.
When did he go to the doctors? - Dates
What were the symptoms?
What was the treatment?

If his notes show frequent visits to the doctors with bowel related symptoms then you need to know if there is any guidance or protocols as to when someone should be referred for further investigation.

Additionally you could check with an expert when they would regard it as usual to refer someone with these symptoms.

Did Jim have any other risk factors e.g. bowel disease (e.g.colitis).

I don't know if you have enough information yet to know whether or not there is a case and I am not a medical neg specialist. I think it is reasonable that you check the medical history in a bit more detail before deciding whether or not this can be taken any further.

I think people would be surprised at how little GPs record in medical notes. I emigrated so paid for a full copy of mine to take with me. 40 years of notes with just 5% max of my contact with them recorded.

It's entirely possible that those earlier appointments weren't recorded and sadly therefore what you know and what you can prove don't match.

I'm sorry for your loss.

I have a copy of my own medical notes and we have DH's too because we had to fill in life insurance forms and of course they want to know when you were seen for X illness. We simply couldn't guess.

We contacted the GP surgery, put it in writing as requested, paid £10 admin fee for each file and then a few days later we collected the photocopies (pre-computer) and print outs (latest stuff) of our files enabling us to fill in every detail of the form.

I used to work for the health authority and part of my job was medical file storage for archived files (deceased patients) transfers both in and out of area before everything became computerised.

Contact the GP today and find out what they need. As Jim cannot consent himself I am unsure what they will need from you/his wife. But you need to see those files for yourself.

Luckily with the internet at your fingertips, knowing what a drug is prescribed for doesn't require a GP to tell you.

Okay, but Anne could instruct another firm further down the line couldn't she?

It's awful that £2m has been mentioned, but I really don't think going on a mission right now is the sensible thing to do, if there's no immediate need.

It is all really sad, but if he hadn't worked in years prior to this diagnosis, she is going to have an even harder time proving that she has been financially disadvantaged by his death.

Re the pension, if he has ever had a pension in any previous jobs, it is worth tracking down the company and seeing what can be transferred to her. It doesn't have to be from the most recent job he did...

Look from a legal point of view, if you have an expert witness that isn't saying what you want to hear, I would suggest getting a second opinion. But this is going to cost a lot of money and time and effort. Plus, you will have to declare this in your case. if you want to do this, instruct your solicitors to do so - they will advise you against it but they're not going to say no if you are paying.

Medical professionals work within prescribed procedures and budgets which are often non-negotiable. This means that every single person isn't sent for every single test that could possibly be given relating to whichever part of them is in issue. It's going to be very hard to prove that a colonoscopy should have been done if his description of his symptoms and what the doctor could see all pointed to piles. Piles can be mild or really bad and are often recurring, so I am not surprised they didn't necessarily send him for a colonoscopy.

Might your time and resources be better spent lobbying and writing etc to try to get a policy change in the NHS to get people with recurring piles symptoms sent for colonoscopies rather than trying to get compensation? Suing the NHS doesn't sit well with me - nothing is perfect and litigation against medical professionals is often a huge part of the reason that we struggle to get qualified doctors and nurses in this country.

That valuation makes no sense whatsoever for someone who hadn't worked for a few years anyway. The claim is worth the extent to which Ann and anyone else was financially dependent on him (plus some odds and sods on top), which was presumably fairly minimal if he didn't earn.

How do you know he went to the GP a few times in 2012? Just because he complained to you doesn't mean he (a) went or (b) complained about the sort of symptoms that would/should wave red flags.

Hoping someone else with more expertise comes along soon. IMHO (which, if I'm honest is probably not hugely well informed) I would want to pursue this, whether now or once things are more settled. I think the sensible option is to get a copy of the medial notes asap and perhaps ask for a second opinion. Surely a man in his 50's (assuming Jim's age, based on Ann's) with ongoing stomach and gut pains and rectal bleeding raises a red flag and should be referred on?! The fact that he was seen by multiple hcps and not one of them thought about the symptoms (or beyond diagnosis of a bad case of piles) enough to think he was a cancer risk strikes me as being dismissive, lazy and incompetent medical care. I may be biased though, my family have HNPCC so are regularly screened for bowel cancer.
Op, maybe wait for a medical type person to post... Sending my condolences.

OP the solicitor should be able to request a copy of all jims notes from his gp. As your claim will be against the drs practice it will probably have to be requested through the governing body.

I could nearly have written this post myself. my grandmother died in similar circumstances. gp kept telling her she had ibs for a year until my mum sent her private she lived for nearly another year. However we never pursued anything as me and mum both work in solicitors an and know how lengthy these cases r and in the end it wasn't going to change anything plus we had my granda to look after until he died 5 months later.

I am really sorry for your loss.

I think if the independent experts are advising not to pursue this then I would heed that advice.

However, if you really feel that is not the right path for you then could you approach another solicitor and another medical expert for a second opinion?