Total Damages: £8,500
Trial/settlement date: 18/8/2004
Type of Award: Out of Court Settlement

Court: Out of Court Settlement
Age at trial: 68
Age at injury: 64

Sex: Female
The claimant, a widow, received £8,500 for the death of her husband following the failure to diagnose a caecal tumour in December 2000. The deceased suffered from acute abdominal pain, chronic constipation, drastic weight loss, nausea and intermittent vomiting. He also suffered from pleural plaques and pulmonary mestatases.

Claimant: Female: 64 years old at date of accident; 68 years old at date of settlement.

The claimant was the wife of the deceased (D), who died on 27 July 2002, aged 71.

Clinical Negligence: D suffered from chronic constipation, lower abdominal pain, nausea and ongoing weight loss. In approximately October 2000, D was suffering from a persistent chest infection and his GP referred him to a respiratory specialist. Chest x-rays were taken in February 2001, which revealed pleural plaques consistent with previous exposure to asbestos.

Between October and December 2000, abdominal investigations were carried out by a specialist registrar. A barium enema was taken but, due to excessive barium, the registrar could not find any significant abnormality other than diverticular disease, which confirmed a previous diagnosis made by barium enema in May 1999. However, she noted that the caecum was distended.

In February 2001, a CT scan was taken, which revealed a dilated common bile duct. D's kidney and liver functioning however, was shown to be normal.

By June 2001, D's condition had deteriorated and he had lost over five stone in the previous year. He was therefore referred to a gastroenterologist who performed an ERCP and a sphincterotomy and concluded that the dilated bile duct was due to a choledochocele. He also arranged for a repeat CT scan, which was taken in August 2001 and showed no further significant abnormality.

On 6 October 2001, D was referred to hospital as an emergency patient on account of his deteriorating condition. On 9 October 2001, D underwent a laparotomy and was found to have a caecal carcimona. He was discharged on 20 October 2001.

In November 2001, D complained about the diagnostic delays. On reviewing his case history, the consultant noted that in retrospect a small caecal tumour that the barium enema had not revealed could be seen on the CT scan which had been reported as normal. He was referred to an oncologist who concluded that he would require chemotherapy on account of a moderately differentiated adenocarcinoma of the colon with enlarged lymph nodes.

By April 2002, D had undergone 12 weeks of chemotherapy. He had initially shown good progress, however by July 2002, D was in pain and suffering from breathless from his pulmonary mestastases. Further chemotherapy was of no benefit and his prognosis was measured in weeks or months. On 16 July 2002, D was admitted to a hospice and he died on 27 July 2002.

The claimant brought an action against the defendant alleging that it failed to: (i) properly investigate D's symptoms between October and December 2000; (ii) request full blood investigations including ESC and C reactive protein as markers of inflammatory or malignant process causing weight loss; (iii) review D's case and to request a CT scan or other investigation; (iv) carry out a technically adequate barium study;(v) recognise the technical inadequacy of the barium study in outlining the caecum because of excessive barium;(vi) requisition colonscopy; and (vii) diagnose the D's cancer by December 2000.

It was the claimant's case on causation that as a result of the above negligence, the opportunity was lost to carry out a right hemicolectomy and adjuvant chemotherapy in December 2000 or shortly thereafter. If this treatment had been carried out, D would have been saved from nine-to-ten months of symptoms of acute abdominal pain and his symptoms would have been relieved providing him with a better quality of life.

Liability admitted. The defendant accepted that there had been a breach of duty, specifically regarding the additional pain and suffering of D between October 2000 and his subsequent death on 27 July 2002. However, both parties agreed that D's life was unlikely to have been prolonged by an earlier diagnosis.

Injuries: D suffered from a caecal carcinoma with acute lower abdominal pain, chronic constipation, drastic weight loss leading to anorexia, nausea and intermittent vomiting. He also suffered from pleural plaques and pulmonary mestatases. He died after a course of chemotherapy.

Effects: The claimant was left without a husband.

Out of Court Settlement: £8,500 total damages.

Background to damages: There was, however, no viable claim for dependency or loss of services due to the deceased's ill-health.

Withy King for the claimant. Salisbury District Hospital in-house solicitor for the defendant.

LTLPI 29/3/2005 (Unreported elsewhere)

This Quantum Report was provided courtesy of Simon Elliman of Withy King, solicitor for the claimant.

Document No. AM0200715