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Case Number 1 Return to Case Studies

 

Mrs. Anne Y - Problems with obtaining a genuine reassessment of her medical condition.

SIN has become alarmed over the last few months at the deterioration of Anne's health and the increasing levels of distress and frustration experienced by both she and her husband at their inability to get her health concerns addressed. Anne has given her permission to publicise her plight.  Anne has given thirty years of valuable nursing service to the NHS and rose to the highest level, becoming a Nursing Practitioner.These are the more relevant facts:

  1. Anne became ill three years ago with pain,obvious bowel symptoms and severe weight loss  (3 stones).She underwent a series of tests at her local hospital and at a major  one in London. All were apparently negative. She subjected herself reluctantly to an hysterectomy and removal of her ovaries on the understanding that these were thought to be the cause of the problem. Unfortunately her intestinal symptoms persisted and steadily worsened, and to make matters worse, she was told that her ovaries had been healthy!! She was retired on health grounds.

  2. Her husband and neighbours, alarmed at the distension of her abdomen and the deterioration of her health, wrote individually to the CHC about their concerns. To see for yourself the cause of their concerns, click here to view photographs of Anne taken before her illness three years ago, and at June this year.
  3. Mr & Mrs Y, in desperation, presented themselves at the A & E Department at the local Hospital. Doctor on duty, examining Anne, immediately ordered a set of tests. Mr & Mrs. Y were shocked and humiliated when a radiologist informed them, in front of the waiting patients, that he had no intention of carrying out these tests. 
  4. Anne was referred to a second London hospital in London for a complete reappraisal of her medical condition. In October 1999 a sympathetic consultation surgeon, said to them both that in his opinion her condition could be a result of one of three options:
    1. A non-obstructive intestinal cancer which had been missed. 
    2. A "functional" diagnosis made by first hospital.
    3. A psychological problem which he could dismiss.
    The surgeon referred her to a physician, for assessment.
  5. Mr & Mrs. Y were shocked to receive a letter from this physician, dated 24th Nov. 1999, in which the doctor made it clear that he was unlikely to agree to further tests, even though he had neither met nor examined her.  Anne felt unable to accept the precondition of this consultation which could only go ahead provided she agreed not to ask for further tests, since this was the very purpose of the consultation
  6. In desperation, Mr. Y wrote to the Chief Executive of this hospital pleading with him to intervene so that Anne could be seen for a genuine re-appraisal with  fresh tests. 
  7. Possibly in response to this letter, the physician wrote to Anne’s GP and suggested that it would be of benefit to refer Anne to some other physician and include only a brief outline of her previous tests.
  8. The Chief Executive replied to Mr. Y stating that he could not compel the physician to see his wife, (how then is a patient to gain a second opinion?) **and suggested that Anne should contact her GP.
  9. Anne was upset and astonished when her GP suggested a referral to a psychiatrist!. It is important to note that Anne has, under her own insistence, seen three psychiatrists. Each one cleared her of having any mental problem, none prescribed medication and each one urged her to see a physician since her symptoms indicated a physical, medical condition
  10. Anne tried to obtain a consultation with a surgeon, at a private hospital locally. She was assured that he would see her, but wished to read her notes first.  She was shocked to receive a letter from the consultant’s secretary stating that he was refusing to see her and recommended that she took the advice in the first consultant’s letter, dated 14th February, 1997 to be referred to the first  London hospital. Anne had followed this advice three years ago! 
  11. A few  weeks ago Anne telephoned SIN in a very distressed state having had several bouts of diarrhoea and, feeling faint, had contacted her GP’s surgery for a home visit, but no one had arrived.SIN, at Anne’s request, telephoned the surgery and found that Anne's GP was off duty. SIN spoke to a female colleague, who said she would attend to the matter and telephoned Anne to assure her that she would be visited. Anne called again, very distressed, to say that her own GP had told her that no doctor would visit her and that she could not see any other GP in the surgery but himself. Other patients at the Practice are allowed to see whichever GP they prefer! 
  12. Friday, 26th May, 2000 Anne had an ultra-sound test arranged by her GP. The Radiographer was v. concerned about the state of distension of Anne’s abdomen. The test was negative, but the radiographer said: " it would only show a large obstructive cancer". Anne was told she urgently needed a series of tests. Her GP admitted that he knew she did not have symptoms of an obstructive cancer since she was not vomiting. 
  13. Week beginning 5th. June, Anne 'phoned the second hospital and asked if she could be admitted. At Anne's request SIN rang the hospital to emphasise the urgency of the situation..At 5pm that evening SIN was contacted by the General Manager of the Critical Care and Surgical Unit stating   that Mrs. Wells would not be admitted.  Anne received a similar call.  She asked for the refusal to be put in writing - the letter finally arrived on 27th June, containing the advice that Anne should go to the local hospital! 
  14. Anne and her husband called her GP out  one evening. Mr Y and Anne( in tears) pleaded with him to admit her to hospital. The GP refused, although he admitted she had deteriorated, on the grounds that she did not have an" acute abdomen " - meaning there was no obstruction. The fact that she may have a non-obstructive cancer was ignored.
  15. Anne wrote to the Secretary of State for Health on 21st March 2000. The Regional Office was asked to investigate. The Health Authority has done its investigation - without involving Anne, the patient!! SIN considers such an investigation "null and void" .

  16. Anne's health has seriously deteriorated. Her symptoms have considerably worsened and changed over the last eighteen months and she has received no specialist care. She has a very distended abdomen and looks 6 months pregnant. She is in a great deal of abdominal and back pain, for which she is on a high level of pethidine., and has difficulty in walking. Her quality of life is poor and she spends a great deal of her time resting in bed. She has little sleep at night because of the constant pain. She has attacks of diarrhoea, feels nauseous and eats little. She is only 48 years old, feels desperately ill. In desparation, friends of Anne have written to SIN asking for help.
    Click here to see a letter recieved by SIN in June this year.

    In spite of strenuous efforts  Mr & Mrs. Y have failed to obtain a genuine medical re-assessment of her condition, based on fresh tests.  She and her husband have tried very hard to raise their concerns in all the appropriate places*. The recent appalling case of Mr. Steve Harley, 41, from Barnsley reminds us that, sadly for the patient, on occasions, cancers can be inexplicably missed. He was seen on no fewer than 22 occasions, by 12 different doctors before his extensive cancer was recognised and, incidentally, he had had several investigative tests – all of which were apparently negative!


SIN believes that Anne has not received the consideration and quality of care to which she is entitled. She has been subjected to cruel and disgraceful neglect as her cries for help have gone unheeded. Professional people do not go to these lengths unless something is very seriously amiss. SIN has taken Anne's case up with her MP, the HA, Regional Office NHSE and the Secretary of State for Health.
 

** On 29th February at St. Thomas’ Hospital, London, on a BBC2 Newsnight programme, the Prime Minister reminded doctors that clinical care for clinical need was MANDATORY!
 
 
 
 

Click here to hear Anne talking about her illness

Click here to see photographs of Annes condition before and after she became ill.

Click here to read a letter to SIN from Anne's friend.
 
 
 
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