AIBU to even consider medical negligence

[wildflower93]

My partner has had a horrendous few months and I’d really appreciate some perspective from medical professionals about whether I’m being reasonable considering medical neglect. My partner has now lost 4 weeks of earnings (private company with no sick pay) and we’re due to move into our forever home.
In December he had a burst appendix with peritonitis and septic shock, AKI and major complications. His CRP hit 600 and he was critically ill. He almost died. When we met with the surgical team upon admission and they all knew of him and his ‘mucky’ operation. He’s become a surgical legend to the team.
For months afterwards he had ongoing abdominal pain, nausea and vomiting. He was admitted again with what looked like gallbladder attacks but was discharged after and told it was gastritis/gastroenteritis. Ovrr two weeks ago he began suffering with stomach pain again and turned bright yellow. The GP fobbed him off and sent him away so we eventually paid privately for an ultrasound which showed gallbladder sludge. He was readmitted, with liver markers around 150, and had an ERCP to remove stones/sludge which was ‘successful.’
Two days later he began to pass black, tarry stools and became very unwell. He told his nurse on 4 occasions between 10am and 7pm. She failed to escalate this as the medical emergency that it was. I only found out when I arrived in the evening and had to push for review, eventually invoking Martha’s Rule. He was found to have a significant GI bleed with his haemoglobin dropping from 148 into the 80s/90s. I genuinely believe without escalation he could have continued bleeding unnoticed. He is now severely anaemic as well. He had ANOTHER camera to stop the bleeding. His blood markers continued to fall for 4 days and they took a ‘wait and see’ approach instead of providing him with a CT to assess whether the was still bleeding.
After that he improved, but his CRP rose again from 10 to 49 and then 106, with fever, raised white cells and bilirubin. Antibiotics were delayed until the following day and they are still trying to find the source.
I’ve lost all trust due to repeated failings, delays, and having to advocate for him and effectively piece things together myself.
Two questions:
AIBU to be looking into medical negligence? I don’t think I could ever realistically sue the NHS, but I feel completely lost. My brain is everywhere and I’m trying to stay strong for my son but I’m struggling. He’s likely going to miss my son’s 4th birthday and I just need somewhere to focus my anger and helplessness right now.
Is a CRP of 106 considered catastrophic, and is it normal that they still can’t find the cause? I’m terrified he won’t get out of hospital.

I’m really sorry you’re going through this, I hope he’s on the mend soon. I’m a doctor, although not a surgeon.

A CRP of 106 is high, but not unusually so for somebody with an active infection. It wouldn’t be described as catastrophic. And yes, it can be difficult to pinpoint the site of an infection, and often they will start treatment empirically with broad-spectrum antibiotics while they look for it.

To establish medical negligence, you would have to prove (1) that a duty of care existed, (2) that the care he received fell below a reasonable standard, and (3) that he suffered direct harm as a result. It’s hard to know at first glance if his care was unreasonably poor - surgical complications in themselves are not evidence of negligence, and the more unwell someone is when they have surgery, the more likely it is that there will be complications. It does sound like they were slow about reviewing him when he deteriorated, but whether this delay has led to any permanent or serious harm is a different question - and it sounds like there’s every chance he will make a full recovery.

I would say, OP, that negligence cases tend to be prolonged and very stressful, and while it might feel like the only thing you can do to help at the moment, I think it would be a mistake to rush to any decision now. And it would be his decision, ultimately, rather than yours. I hope you’re able to get some rest today and that you see signs of improvement in him

as pp, it’s not at all clear cut from your description whether there is/was negligence or just bad luck. It may eventually be worth him exploring why it took a while to spot the GI bleed and whether that might have affected his recovery. CRP is not always as useful as I think you think. ‘Watchful waiting’ often is a reasonable plan. Bottom line is that no one here can tell you if there’s been negligence/bad luck. Sounds like he’s had a rough time & his energy may be better spent focussing on recovery at the moment rather than the complexities of a complaint (because it’s him that would need to make any complaint rather than you).

I think proving negligence would be extremely difficult as it’s a high bar. A complaint to PALS may be the best starting point. On the CRP, it’s high but not alarmingly so. I have an autoimmune condition and mine often is higher than that when I’m in a flare or a bit run down.

Wishing him a speedy recovery!

There is no rush to act now, you have three years from being aware of the issue. Best focus on getting him well again first and then submit a formal complaint under Patient Safety to see how they respond. It may also be worth submitting a Data Subject Access request(DSAR) for copies of his notes and PALS can advise you how . The threshold for negligence is quite high to prove. Wishing him a good recovery.

Thank you.

I think he has just been incredibly unlucky. It’s just the one nurse who failed him massively by making out he was being ‘dramatic’ raising his concerns about black stools.

They also failed to diagnose it as gallbladder disease last month.

They think it’s a chest infection (he’s been lying down a lot!) and think his gallbladder may be blocked again… so it continues.

Personally I’d write it all down and gather all the facts, print outs, copy medical records etc and diarise it all. Then you have everything you need if he decides to pursue.

At the very least formal complaints about nurse who ignored blood in stools, and GP. Even just writing the letters focused on those two specific issues may be cathartic. Hard to believe a GP ignored jaundice (cause of yellowing) - was it actually a doctor he saw?

Just to add sympathies on your position, it is terrifying watching someone close to you suffer so much and feel so helpless in the face of medical and nursing incompetence/lack of care/plain ignorance.
In my own family's cases one went down the legal route but most of the (small) financial award went to pay costs (this was many years ago). In the other case it was not pursued legally, partly because the real negligence occurred abroad (in a civilised EU country before Brexit) so would have been complicated, and partly because our focus had to be on recovery of relative, and it was too traumatic to spend time thinking about what had gone wrong before.

I used to work in clinical negligence, although quite a while ago. Pp is correct about the 3 year limitation, so there’s no need to make any quick decisions.
If you make a successful claim, most of the compensation payment will likely be lost earnings, so unless they will have to change job for something lower paying, or they’ll be off work for a considerable time, the compensation may not be worth the aggravation of making the claim.
i would suggest first of all making a formal complaint and hopefully that will help you reach a resolution. If not, then you can consider making a claim.

Yes! It’s just crazy. She took bloods and sent him away. Said ‘you look off but only a bit yellow.’

He went to work! Was sent home like a Simpson. That’s when I booked the private ultrasound because we’d been fobbed off by GP and A&E time and time again. They did a CT and said ‘it would show gallbladder disease’ but when we spoke with the gastro surgeon 2 weeks ago he said ‘that’s silly as it only shows on 12% of cases on CTs and diagnosis is ultrasound.’

Funnily enough, he had 10 missed called from his GP the day after !

As someone who at one time was the admin link for complaints and claims in a hospital trust I would say it’s very unlikely a negligence claim would get anywhere at all, but from what you’ve said here a complaint would be very much justified.
Before I moved to another job I can say hand and heart that there was a procedure to follow when complaints were received, that they were always fully investigated and responded to within a set period time and a brief summary submitted to the monthly Board meeting where questions about them were sometimes asked.
Nowadays the procedure might not be the same but I’m still naive enough to hope that when complaints are made it might prevent similar problems and upset occurring in the future.
If it were me I wouldn’t be raising a formal complaint now whilst he’s still in hospital but please don’t be afraid to share your worries with those responsible for his care about the slow progress he seems to be making and ask what the next steps might be - don’t assume they must know what they are doing.
With the worry of your husband in hospital, visiting him and a little one to look after you won’t have a lot of free time, but as suggested above keep careful notes of dates, times and names so that if you decide to pursue a formal complaint later you have an accurate record of everything that happened