Decision report 201101517

Summary
Mrs C complained to the board about the treatment her late husband (Mr C) received at Ninewells Hospital in January and February 2011. Mr C had been attending his GP surgery since November 2010 with breathlessness, cough and weight loss. Mr C attended the hospital's A&E department in late January 2011 and after seeing a nurse and a doctor he was sent home and told to wait until the GP referred him to hospital. No medical assistance was given.

Mr C attended the respiratory clinic ten days later where he was x-rayed, weighed and had bloods taken. He was told he did not have cancer. Eight days later, the GP arranged for Mr C to be admitted to hospital that day and a CT scan was carried out two days later. The scan showed evidence of widespread infiltration of the lung, suggestive of malignant disease or infection. As the scan was inconclusive a biopsy of the lung was carried out the following day. The result indicated that Mr C had lung cancer which was rapidly progressing and which was unusual for a non-smoker. It was decided that Mr C should be transferred to a community hospital, where he died two weeks later.

We upheld Mrs C's complaint that her husband was unreasonably turned away from the A&E department when she brought him there when she was concerned at his condition and the lack of urgency shown by his GPs. We also upheld the complaint that when Mr C attended an outpatient appointment he was incorrectly told he 'definitely did not have cancer'.

Recommendations
We recommended that the board:
• remind nursing and clinical staff in A&E of the need to complete nursing and clinical records in accordance with the Nursing and Midwifery Council and General Medical Council guidance; and
• apologise to Mrs C for the failings identified in our investigation.