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Patient’s lung cancer only found after seven-month delay in arranging X-ray

Patient’s lung cancer only found after seven-month delay in arranging X-ray

A Fife medical practice has been told to apologise to a patient whose lung cancer was only diagnosed seven months after she first reported a cough.

The woman, known only as Mrs C, complained to the Scottish ombudsman about the standard of medical care she received when she reported a cough to the practice.

The patient reported a persistent cough on two occasions, but was still not referred for a chest x-ray.

It was only at a third consultation seven months after the first time she reported the ailment that a locum GP sent her for a chest x-ray and, after further tests, she was diagnosed with the disease.

The ombudsman took independent medical advice from a GP adviser who found the practice missed two opportunities to arrange for Mrs C to have such an x-ray as part of its routine investigations into a persistent cough.

The investigation found that the practice failed to reasonably follow the national referral guidance for suspected cancer, which all GPs should be aware of and which clarify the significance of a cough in the diagnosis of lung cancer.

This states that a timeframe of three weeks should be considered as a persistent cough. When Mrs C first discussed the cough, however, she had had it for eight weeks. When she next mentioned it, she had had a cough for 13 weeks.

“The criteria for referral for suspected cancer had been met on both occasions.

“We found that Mrs C should have been sent for a chest x-ray earlier than she was, so we upheld her complaint,” the ombudsman’s report concluded.

A number of recommendations were made to the practice, including:

* Apologise to Mrs C and her family for the distress caused by the late arrangement of investigations in the cause of her cough

* Notify the board’s clinical support group and ask it to consider whether to undertake a random review of patient consultation records for quality assurance purposes

* Carry out a reflective significant event analysis with support from the group and provide the ombudsman with a copy.