The clinical negligence team at Penningtons Manches LLP has issued proceedings in the High Court on behalf of a client who is suffering serious damage from a failure to interpret and report test results properly, resulting in a delayed diagnosis of pulmonary emboli.

After a long haul flight back to the UK, the woman experienced severe shortness of breath and chest pain. Following an initial assessment at her local hospital in Surrey in October 2007, the doctors suspected that the cause of her symptoms was either a severe exacerbation of pre-existing asthma or pulmonary emboli. Consequently, she was admitted into hospital for a CT pulmonary angiogram to confirm or rule out the possibility of a pulmonary emboli. As the first scan proved inconclusive, a further scan was performed two days later, the results of which were verbally discussed between the treating respiratory physician and the radiologist the same day.

Unfortunately, the radiologist failed to interpret the results accurately and advised the physician that there was no evidence of pulmonary emboli. Consequently, the woman was discharged home with a diagnosis of a chest infection. A few days after discharge, the results of the scan were reviewed by another radiologist and a formal written report was compiled which correctly noted the findings of ‘bilateral subsegmental pulmonary emboli’. Despite these worrying findings and the evidence of the patient being discharged home with the wrong diagnosis days previously, no action was taken by the hospital to notify and recall her or to ensure that she received the appropriate treatment. Based on the clinical negligence team's expert evidence, a blood thinning medication such as warfarin would have disbursed the clots within only weeks, ensuring a complete recovery without surgery.

However, the woman was never informed of the correct diagnosis and no action was taken to instigate treatment. Over the subsequent years, she continued to suffer with chest pain and shortness of breath, which she attributed to her asthma at the time. Upon her return from holiday a number of years later, she suffered further respiratory problems which persisted despite taking antibiotics. She was subsequently referred by her GP for further investigations at the same hospital where the error became known. Unfortunately, the emboli could not be treated conservatively with warfarin and she had to undergo a thromboendarterectomy, a major surgical operation.

The combination of the missed diagnosis, the failure to act on the right report, a significant delay in treatment and major surgery has significantly affected every aspect of her life causing her much distress and unnecessary, avoidable harm.

The clinical negligence team obtained expert opinion from a consultant respiratory physician and radiologist which determined that the pulmonary emboli were clearly evident from the second CTPA scan. The experts were also very critical of the hospital for failing to put ‘safety net’ procedures in place when the scan results revealed adverse findings days later. After submitting a letter of claim to the trust, a full admission of liability was received. Court proceedings have recently been issued to protect the claimant’s position due to expiry of the limitation period and to allow time for further investigations to be conducted on the impact of the missed diagnosis.