" 

• Mis-diagnosis
• Damage denied
• Deliberate denial of specialist  cardiac care: a "cover-up"
• Character assassination
• Failure of Chief Executives to protect
• Failure of NHS Complaints Procedure to protect
• Failure of Regional Office to protect
• Failure of D.o.H to protect
• Dubious "expert witnesses" 

In 1993 some doctor had the great idea that this severe chest pain just might be cardiac. Gill was diagnosed with coronary artery spasm  following a stress ECG + other  cardiac tests; was immediately put on cardiac drugs and given early retirement on health grounds. She saw a cardiologist every 3 months  but was repeatedly assured that she had suffered no damage what so ever - naturally she believed them. ( Don't we all believe them ?).Eventually she became aware that the summaries of the consultations were bizarre and very misleading and she accessed her medical records and discovered that certain tests suggested that very serious damage had been sustained, in keeping with years of coronary spasm without the benefit of medication. 

Having moved area Gill attempted to discuss her concerns with the local cardiologists, only to be met with evasion, aggression and eventually verbal and written abuse. (Sounds  familiar?) None of the tests showing damage had been obtained and any discussion was denied. Effectively, Gill has been denied specialist cardiac care for over five years by the local cardiologists in spite of having  the following  stated in wriitng or in tests results:

• cardiac diagnosis: coronary spasm/ prinzmetal angina
• cardiac drugs: Istin ; Imdur ;  beta-blocker ; GTN spray; moduretic tablets to relieve symptoms of heart failure.
• a well established heart attack. In 1993 this was visible on the tracings. The defiition of a heart attack is the presence of 'Q' waves which should be "one mm wide and/or 2 mms deep"  Gill's "Q" wave is now 7mms long with a permanently inverted "T" wave of 3mms which indicates that part of the heart is permanently deprived of  oxygen called "ischaemia".  Gill has an "inferior myocardial infarction" which means that the bottom of her heart has been damaged - this has been written down in certain hospital notes - but not in others!  Damage in this area affects the nerves at the centre of the heart and causes irregular rythmns.
• anterior - lateral damage showed up in one test.
• a stress ECG which showed poor cardiac reserve. Gill only achieved 3 METS and even at this low level her ECG showed "marked ischaemic changes" ( elevations and depressions) and was "grossly abnormal" - all without pain, indicating that  Gill suffers from "silent ischaemia" when exercising.
• 24 hr. ECGs show hundreds of irregular rhythms  and tahcycardia ( fast heart rate)
• X-ray shows an enlarged heart
• serious heart operation has been suggested in one letter.
• symptoms of heart failure

Gill's quality of life is very poor. She must rest a great deal, if she has a normal day  out she becomes very tired and swollen with heart failure and must rest in bed for several days to recover.  Her prognosis is given as "uncertain".

(Gill, like Margaret, knows she has been cheated of many years of benefit because doctors have lied and mislead her. She has lost her career and her pension - if she had had medication  earlier,  her heart  would have been protected from damage).

NHS Complaints Procedure
She attempted to go through the NHS Complaints System which failed to protect her. Three attempts to get an  Independent Review were  thwarted  in a most unprofessional  if not unlawful manner. Gill complained to the Ombudsman's office and to the Select Committee on Parliamentary Administration,  call ing  for resignations at that Office ( Do we hear cheering?) Two high ranking officers departed, one for retirement, the other moved to the GMC {Presumably to continue the work of protecting doctors and misguiding patients?).

Complaints to the Regional Office in addition to attempting to go  through the NHS Complaints Procedure -  several times, Gill alerted the authorities as early as June 1996 to the fact  that she was being denied specialist cardiac care. She contacted the Regional Medical Officer ( RMO) and the  Chief Executive of the Health Authority, naively thinking that since they were paid to to protect the patient they would take immediate action on her behalf. Both refused a meeting. The RMO dashed over to the hospital involved,  presumably  to get the statement signed by the Chief Executive and Medical Director, claiming  there was no substance in Gill's  concerns. This statement  would have been a lie. Once back at Regional HQ the RMO would no doubt  have faxed it to D. o.H in London & Leeds,  thereby ensuring that should Gill have the temerity to seek the help  of  the Secretary of State for Health, there  would be a false statement waiting  in her file which would negate any need for action.

( We now have public evidence in the Rose Addis case that Trusts  lie with impunity,. This Trust lied to the public and  did not hesitate to  implicated the Secretary of Health & the Prime Minister in their web of deceit  woven to protect themselves.)

Request for Formal Inquiry at D.o.H
Gill & her husband did in fact ask the D.o.H three times  for an Inquiry into her situation. How could anyone with a serious heart condition be denied specialist care in this country? Once  a civil servant told her she was to get a meeting - however, this never materialised. Each time, however,  it was refused. It was not until much later  that Gill discovered that her suspicions had been true:  Indeed the Chief Executive of the local Trust, had issued lies to the civil servants of the D.o.H in 1996  in order to discredit her, claiming that she had been seen by local cardiologists but that cardiac tests were negative. Gill had received no cardiac tests except for one rest ECG which she later discovered showed a heart attack, although it was not noted.  Presumably this is why no one can write down that she has had one.
The third time, their letter  never reached the Secretary of State for Health but was diverted  - guess where? - to the Regional HQ to be"investigated" !! Gill's husband contacted the Regioanl  Director  informing and warning him of the deceitfuf infomation which had been disemminated into the system .. her husband demanded, and expected to get an immediate meeting to discuss this incredibly serious matter. Astonishingly, when nothing materialised, her husband contacted the Director's Office to tbe told by his secreatry that there would not only be no meeting , but there would be no reply to his letter! The cover-up was firmly in place!

In spite of letters to the hospital, Regional Office, and D.o.H the family have been unable to get this false statement  addressed and rectified. ( A Head of a school issuing untruthful statements about a pupil would have been dismissed). Gill's husband rang the D.O.H London,and said:" "For the last time my wife has had no local  cardiac care and no cardiac tests" The cool civil servant replied " "We have to believe them when they tell us these things!"

(Obviously, this incredibly stupid attitude is still in operation - witness Rose Addis. Certainly the lives of the civil servants are very easy : no messy problems to deal with!! What are we paying them for?)

No help from the CHC
Horror of horrors, Gill discovered these lies  have been transmitted to the CHC and out to the local councillors and even to the local community ( So much for confidentiality).  The CHC is not independent and reports to the Regional Director & the RMO, who have a vested interest in covering up problems.

Patient Abuse in an NHS Flag Ship Hosptial 
In Jan. 1997 Gill was taken ill in a local hospital whilst inspecting medical records, she had a moderate attack of angina  and found she had forgotten her spray.  Although a suspected heart attack was written down it took 2 hrs. for a doctor to see her. She has since  discovered that when someone has an attack of  Prinzmetal angina the peaks above the line of an ECG tracing become elongated and will reduce over time. Gill now believes that this was the reason she was made to stay in a room on her own without medical assistance. Her husband  was called  from work and he  suggested that he should drive his wife to the Cardiac Unit immediately.  (Literally a few hundred yards away on the hospital site). This was refused, and no reason was given. Eventually an ambulance arrived, over one and a half hours after her attack, to drive her, not to the Cardiac Unit , but to the Assessment Unit. It was another half an hour before a Junior  Doctor  saw her. She was thus twice  refused access to the  Cardiac Unit, and access to a cardiologist was denied throughout  her stay  in that hospital.

Gill received 2 rest  ECG tests,  a chest X-ray and blood tests. A Junior doctor listened to her heart , noted the heart attack on the ECG . He listened to her abdomen, which Gill thought was rather curious since she had a cardiac condition!  Gill informed him that she had had a pulsation in her stomach for a few years. He told her this would be her aorta and was nothing to worry about. She then tried to discuss with him the additional  information she had disccovered in her medical records. He refused to write anything down and although Gill had, by chance the documents with her and offerd to show them to him. He refused to look at them, saying that he could only look at the ECG. The GMC clearly states that " a doctor should  keep clear , accurate  and contemporaneous  patient records which report the relevant clinical findings...." The clinical governance was bizarre. Gill asked if she could put the relevant clinical details down. The doctor agreed. And so, with permission, Gill wrote in, around the doctor's notes whereever there was space available, the details and signed each one. Gill was fighting for her life, she knew that if remedial action was needed on her heart, then the sooner she obtained it the better.

{ The Doctor's Union , the BMA, gives the following advice to their members: "Doctors must keep 'clear' , accurate and contemporaneous patient records which report the relevant clinical findings, the decisions made, the information given to patients and any drugs or other treatment prescribed.".... " Records must be legible and factual, and personal views about the patient's behaviour or temperament should not be included....", 

.She was shown the X-ray which alarmed her becaue the heart, especially the left ventricle, seemd very enlarged. She requested that she shousld have an opportunity to discuss the matter with a doctor before she left. The Sister assured her that this would happen. At 10pm a different,  very unpleasant  young doctor appeared and  informed  Gill & her husband that they could  go home. Gill asked if they could  discuss the X-ray as promised. He rudely  pointed out that she had seen it already and he  had no intention of showing it to her again, but he would show it to her husband. Her husband said they both wished to see it. The doctor said he was not going to show it to them and marched off. What was Gill to do? They had waited hours and hours, very quietly in a cubicle with curtains drawn around for privacy. Gill followed him down the ward and reminded him of his obligatiosn under the GMC " To listen to patients and to respect their views "  " to treat patients politely and considerately", "to give patients the information they asked for and their prognosis"  This objectionanable young man , moved very close to Gill and towered above her, thereby physically intimidating her and accused her of abusing him. Gill had the presence of mind to  retort that, on the contrary, he was abusing her. 

Gill sought help from the Sister in her Office  ( she had, after all, promised Gill that a doctor would be available) The Sister told Gill that if she did not leave at once   she would telephone for the guards and she would be   forceably removed from the hospital. Gill stood, or rather sat her ground, and  requested that  a manager to be brought immediately. At 10. 45 pm a sympathetic manager arrived. Gill explained that several documents & test results had been changed and and/or had diappeared form her Records and it was essential for her to see the X-ray and even to get a copy of it. The manager replied that Gill could not tell her anything which she did not already know about doctors!!  The manager  arranged for  the doctor to  discuss the X-ray with Gill and her husband .

The meeting that could not take place at 10pm was now taking place at 11pm!  The doctor  was now quite pleasant and said that the blood  Test results had shown that Gill's enzyme levels were raised  (This showed that some damage had been inflicted on the heart muscle). Although other hospitals  would keep her in over night, the "assay" ( standard) for that hospital was higher and so she could go home. Gill asked if her left enlarged  ventricle was "aneurysmic" because a doctor had once suggested this and she also  had a very high heart rate. He replied that she would need cardiac tests to investigate this. The manager reassured Gill that she would be referred to a cardiologist as soon as possible and the doctor would  issue a statement.Gill and her husband finally arrived home.  at 11.45 pm., feeling absolutely exhausted and in a very distressed state! { So much for the caring British Medical Profession and an NHS Flag Ship Hospital!}

 Gill  had  eaten breakfast at 7.30 am, arriving at  the hospital at 10 30 am, had her angina attack at noon,  and returned home   11. 45 pm. In all this time, 16 hours , she had received  one sandwich , half of which she had shared with her husband. Gill now realises that she was discharged very late and  believes that she may be registered as an over-night stay and there may well be fake tests down in her name. Certainly it was highly irreglar to discharge a day patient without a discharge note : she should have been given  one and a copy to take to her GP.

Gill & her husband went  to the hospital  eleven  days later to collect the X- Ray and the  doctor's note.  Gill had arranged over the telephone with the Medical Records Manager that, should  they  have any queries about the doctor's letter,  they  would be able to see him to raise any questions. Gill made it clear that she arnd her husband would not mind waiting for the doctor's convenience, even to wait to end of his clinic..

Cynical, wicked  Attempt to  to somatise Gill's cardiac symptoms
The note was defamatory and grossly inaccurate.It  claimed   the ECG had been normal, that Gill had abused the doctors and nurses, and had scribbled on her notes. No mention was made of the X-ray and it was suggested that Gill was suffering from  imaginary  symptoms.. Gill & her husband, in a state of shock, went to the clinic of the  doctor who had written the bizarre  note to seek an explanation. This doctor incidentally was not a cardiologist, was not a consultant  and had never even seen Gill and was operating outside his field of competence  in making  such an assertion.! ( How despicable and wicked  to attempt to somatize Gill's serious cardiac symptoms!!)  Although many people were waiting  to see him, Gill & her husband were told that  the doctor  was away with 'flue. Gill asked for that in writing,  his  secretary refused to give it. Gill was refused access to a cardiologist - she wished to ask about the enlarged heart & the rest ECG , she was refused access to a Complaints Manager and to the Chief Executive. To the astonishment and humiliation of  Gill & her husband, two security guards appeared  and  escorted  them off the hospital premises. This is to a woman with a very serious heart condition! (Are these people deranged?  )Another  complaint was issued.

It took until May that year before a meeting for the Local Resolution was held. The doctor who wrote the  abknoxious  note was too cowardly to turn up. The Medical Director confirmed that  Gill's rest ECG showed a heart attack, Ischaemia and problems with the left ventricle, although the letter had stated that the ECG had been normal. He did not dispute the diagnosis  of prinzmetal angina.  Gill & her hsuband  asked that the letter be withdrawn, that a sensible, truthful statement be made and that the doctor be disciplined. However,  the Medical Director, who incidentlally is in charge of clinical governance and  is a role model for all the doctors at the hospital,   made it quite clear he had  no  intention of disiplining the doctor who wrote the bizarre letter This was in spite of acknowledging  that the doctor had not seen Gill and, in all probability had not seen the ECG or the X-ray. He insisted  that the letter, however inaccurate,  would stand. This meeting was recorded and a mandatory statement  should  have been issued within 20 days. ( (Gill & her husband are still waiting)  Gill was also informed that she must go elsewhere for her cardiac care.The Ombudsman's Office refused to deal with this blatant  piece of maladministration.

 A Civil servant at Quarry House Leeds, failed to obtain information
A civil servant made strenuous efforts, by telephone and in letters,  on Gill's  behalf to obtain not only  the statement of the meeting but also a written note as to Gill's cardiac condition.
The Chief Executive of the Trust told the  civil servant  to get in touch with the Regional Office;  this Office  told him to get back to the Trust. The Trust then informed him that the Regional Office had instructed the Trust not  to communicate with the civil Servant! It was suggested that the Trust's lawyer had hold the  Trust  not to say anything - defending the indefensible with tax-payer's money and allowing sick people to go without care - is this really what the Health Authority's lawyers are about - is this not colluding with malpractice?

Gill has found it impossible to obtain copies of information which have been sent to the Regional Office by the Trusts to counter her complaints, even though requested under the Code of Openness. Therefore they are unable to check for accuracy. They have been instructed NEVER to bring up this complaint again with the Trusts, Regional  Office or the D.0.H. So much for democracy!!

Experience of Attending a public  Trust Board meeting
Gill was advised by the D.o.H.  to take her concerns to a full Board meeting of the Trust, now open to the public. At a natural break in the proceedings, as the meeting was adjourned for tea and biscuits, Gill stood up to make a statement about the appalling clinical governance at the Trust and the maladministration that she had experienced. The Acting Chair forbade her to speak , forbade her to hand out statements, and then ordered the room to be cleared immediately. Gill asked in turn the Medical Director, The Chief Executive and the Secretary of the Trust, to whom should she write to request a formal meeting. Everyone declined to answer the question. The Acting Chair then ordered in the security guards, ( this is getting very repetitive) who arrived looking very sheepish and apologetic, to escort Gill and her husband, for the second time,  off the premises. ( Are we living in Britain or a Stalinist state? Again think of the stress  on a very sick woman) Gill received another abusive letter from the Trust signed by the Medical Director (No wonder the medical profession is demanding  the continuation of their  "no blame culture" - which  they have had  for 50 years!!) Gill wrote in formally to rquest a meeting with the Board - It remains unswered to this day!.

Just as with  everyone else, Gill has found critical documents and tests missing and documents which have been changed. Gill has been forbidden to enter either hospital to see her records although there are many misleading and false statements which  still remain None of the positive documents are present.

Gill's  health has been deteriorating ,as indeed she was told it would by a "friendly cardiologist" She was told by one doctor several years ago after listening to her heart, that she should be on strong  anti - arrythmic drugs. She has developed other, serious symptoms and the most dangerous aspect of all of this was that when Gill collapsed in town and an ambulance was called, she was denied emergency treatment.  Gill discovered that her  Region boasts a specialist Unit  studying   woman and heart disease. Gill, of course has never been  included in  this study. 

Experience of the law & Expert Witnesses
Gill, as with many of us, has tried to go to law although she cannot afford it,  as she  is unable to get legal aid .  She  naively thought she could pay a cardiologist through a solicitor to take some comprehensive tests  and  who would then write a definitive report of the extent of  damage.(She surely has a right to know the extent of her cardiac damage?) The first solicitor sent Gill to a corrupt "expert" witness.  She did have another stress  ECG, but when she asked  pertinent  questions, he refused to answer, withdrew from the case and waived his fee!! ( at least he showed some integrity - but why did he accept the work in the first place? ) He seemed to be unfamiliar with coronary artery spasm - either he was utterly incompetent or he was lyng|)The next solicitor was older and said that he and his wife( a nurse) had never heard of a worst case - someone with a cardiac  condition being denied care. However, his resolve seemed to weaken when he realized the number of consultants  involved. 

Gill was sent to yet another corrupt expert witness who had not worked in  the  NHS for fifteen years. She had previously checked with him that she only wanted a 24hr. ECG ( she had others and this would confirm whether or no  this cardilogist was bona fide). She also requested that she be given a copy of the test immediately. He conceded both requests. When she met him he announced that there would not be much left of her heart by now. He also confirmed that she had an inferior myocardial infarction. He asked why she wanted a 24hr. ECG, Gill explained it was to record the arrythmias. He said she did not have any arrythmias. Gill explained that they had shown up on other ECGs and that she could feel them Astonishingly he assured her that the ECG would show no arrythmias, "You take my word for it, there will  be no arrythmias!"

 Very perpelxed Gill turned up at the private clinic the next day. Gill explained that she was most interested in recording arrythmias. The nurse informed her  that the cardiologist  had not  asked for arrythmias to be recorded! ( No wonder he said with such confidence that there would be none ). Gill was told she could have the arrythmias recorded if she wished. However, Gill's request to have a copy of the ECG immediately , was refused and she was told it must go to the cardiologist first!. Having now lost all confidence in this  man, Gill declined to have any test done.

The cardiologist was furious  with this decision - he had tried to pursuade her to have several tests done . In his report he denied tht she had suffered a heart attack  Gill rang to complain about his inaccurate report and about the treatment she had received. He said on the telephone : "Anyway, you shouldn't be here , you should be dead by now" and slammed the receiver down. His "expert" opinion stated ( with no cardiac test) that Gillian had an "excellent prognosis". For his he charged £190 .   As Will Powell said at the Health Select Committee in June 1999: "If they won't tell you the truth when  you pay them , when will they tell the truth?". Gill has spent over £7000, has got an incomplete set of records and no independent statements +- no specialist medical care! [ Solicitors & expert witnesses were registered by AVMA!)
SIN believes that any iatrogenic patient is listed in some way on the HA computer data which is  accessible to Trusts all over the UK. ( no confidentiality here!) In this way everyone is alerted to the fact that this patient must not  receive medical care and nothing important must be written down. ie is blacklisted. The Health Select Committee in June 1999 came to the conlcusion that patients are indeed  blacklisted by consultants and doctors.

A & E Experience
Gill has attempted to obtain care when on holiday  when she   had a bad  attack of angina , by going   to the local  A& E. At first the nurses are very concerned and took Gill in a wheel chair and connected  her immediately to a 12 lead ECG. The tracings are always going hay-wire. Then Gill's details are asked for - name, date of birth her address and postal code. Gill has heard the nurse speak to the doctor who then clicks everything into the computer. The next thing the nurse rushes in, pulls all the leads off Gill's chest and orders her to leave the hospital!!. The doctor, of course, never makes an appearance, never listens to the heart or  watches the tracing or records the symptoms, drugs etc. 

This is very similar to Anne's experiences and other members .  SIN also believes that Trusts commit  outrageous and unlawful abuse to force the patient to go to law. - They have no consideration for the trauma through which this puts sick patients..Yet these patients require urgent medical care. Why should they go to law to obtain what is theirs by right? Also the legal system is obviously corrupt Also as long as the law suit lasts -  they will be without medical care -  AND AFTERWARDS . It is mandatory to give medical care on clinical need.

With regards to being seen off hospital premises by security guards. This has been reported by other members. One, a paraplegic, who was seeking medical care, has been forcibly removed from two hospitals in front of his young daughter who was screaming in terror. He was actually told by one hospital doctor that he would not be treated because he was involved in a law suit.

NB SIN has received calls from a large number of women who are obviously not getting the care they need for a diagnosed cardiac condition. UK standards of Cardiology  are some of the  lowest in Europe and women are particularly badly treated and are very vulnerable. A man who gets a severe chest pain is rushed into hospital. A woman gets a similar pain and she is given a bottle of gaviscon.

It would appear that when a mis-diagnosis has occurred, with permanent damage, it becomes impossible to obtain truthful statements or to obtain any genuine specialist care.

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