Decision report 201101109

Summary
Mrs C complained to the practice about the treatment that they provided to her late husband (Mr C). Mr C had attended various GPs at the practice between November 2010 and February 2011 with a persistent cough, breathlessness, loss of appetite and severe weight loss. Mrs C also spoke to the GPs and expressed her fears that Mr C was dying of lung cancer as she had experience of nursing both her mother and mother-in-law through the disease. The GPs told Mr C that he 'definitely did not have cancer'. Mr C was eventually referred to Ninewells Hospital where following various investigations he was diagnosed with lung cancer. He was transferred to a local community hospital where he died two weeks later.

Mrs C complained that the practice's failure to investigate fully her husband's symptoms led to a delayed diagnosis of lung cancer. Our clinical adviser, however, found that the doctors at the practice had carried out appropriate tests in an effort to reach a diagnosis and made appropriate specialist referrals where required. Our adviser found that the initial working diagnosis of lower respiratory tract infection was reasonable and that when the symptoms did not improve specialist hospital referral was instigated which initially indicated that a diagnosis of malignancy was less unlikely. The adviser explained that lymphagitis carcinomatosis is a relatively uncommon presentation of lung cancer and more so in the case of Mr C who was a non-smoker.

Mrs C also complained that the practice failed to take into account her concerns about the seriousness of her husband's condition. However, our investigation found evidence that the doctors had taken on board Mr C's reported symptoms and had noted Mrs C's concerns and did not dismiss them.