The family of a woman who died following a delay in diagnosis of bowel cancer has been awarded compensation.
The woman, known only as Ms N, had been diagnosed with ulcerative colitis, a form of inflammatory bowel disease, as a teenager in 1987. She had regular check-ups under the care of her GP, who treated her with steroids.
By 2000, there was widespread knowledge that patients who had suffered from inflammatory bowel disease for more than eight years were at increased risk of developing bowel cancer and that a colonscopy, a test that allows doctor to look at the inner lining of the intestine, was the only method of screening and surveillance.
It was recommended that a colonoscopy should be performed 8-10 years after first diagnosis of inflammatory bowel disease. This guidance was formalised in the 2002 Guidelines published by the British Society of Gastroenterologists.
However, despite this guidance Ms N’s records show that she was not referred for a colonoscopy.
In April 2003, Ms N complained to her GP of painful defecation and bleeding. Her GP performed a flexible sigmoidoscopy, which examined the lining of the lower part of the colon only.
Her disease remained active over the next few years which resulted in unusual bowel symptoms and fatigue.
Her GP continued to review her with flexible sigmoidoscopy and prescribed ferrous sulphate tablets, enemas and steroids.
In March 2008, Ms N attended the GP surgery complaining of unusual bowel symptoms and fatigue. Her GP sent her for pathology tests. Two results were marked “abnormal, contact patient” but there was no follow up.
Over the following months, Ms N attended hospital four times with abdominal pain, diarrhoea, nausea and vomiting. On each occasion she was told that she was suffering from a flare up of ulcerative colitis, treated and discharged.
In February 2009 Ms N attended A&E, reporting that she was experiencing agonising abdominal pain and vomiting, and was admitted to hospital.
Ms N underwent a full colonoscopy for the first time in March 2009, which revealed a large mass. A CT scan was performed which confirmed that Ms N had a cancerous tumour in the colon which had already spread to the liver. She was advised that she had probably been suffering cancer for a long time, that it was aggressive and inoperable.
Ms N had chemotherapy to prolong her life expectancy. She reacted badly to this, experiencing severe nausea. Her tumour began to obstruct her bowel, which required surgery to insert a colonic stent.
Her condition deteriorated over December 2009 and she died on 11 January 2010 at the age of 43.
She obtained independent medical expert evidence which supported the claim that if Ms N’s GP had referred her for a colonoscopy at any time up to 2005, pre-cancerous lesions would have been detected, she would have been treated and would have survived with an an excellent prognosis.
She would have been able to continue working and enjoying her active lifestyle.
Ms N left two teenage daughters who were dependent on her income. Although the GP denied all liability, the claim settled for a substantial six-figure sum.
Angharad Vaughan, from the medical negligence team at Leigh Day said: “This was a tragic case. Our expert’s advice would suggest that Ms N’s early death and immense suffering towards the end of her life could have been prevented had her GP simply followed national guidelines and referred her for cancer surveillance.”