Trust's failure to diagnose kidney stone

What happened

When Ms S was six months pregnant she went to the Trust's A&E with severe back pain. A junior doctor told her it was likely to be a muscular problem and did not carry out further tests. The doctor told Ms S to take paracetamol and to contact her GP or midwife if she had any further problems. She was then discharged.

Ms S said that later that day, she was taken to A&E at another hospital as she was still concerned. Doctors diagnosed her with a kidney stone and admitted her for treatment. She said staff at the second hospital carried out urine and blood tests immediately and monitored her baby's heart rate.

Ms S complained to the Trust about the care at the first hospital; that the doctor had misdiagnosed her and that no one had checked on the health of her unborn baby. She said the Trust had told her when she complained that there had been no foetal distress, but that she wasn't reassured by this response because it had misdiagnosed her back pain.

What we found

The Trust had not carried out a urine test. The likely results of this would have led to further investigations. This meant Ms S may well have been admitted instead of seeking treatment elsewhere. If the doctor had suspected that kidney stones were the cause of Ms S' pain, a referral to the obstetric team as well as to urology team would have been required. Kidney stones can be complicated by a urine infection and any fever may cause a pregnant woman to go into labour.

The failings in Ms S's care caused her distress and concern for her unborn baby.

Putting it right

The Trust acknowledged and apologised for the failings in the junior doctor's assessment and the investigation of Ms S's symptoms. It acknowledged the need to consider a referral for admission to hospital or specialist follow up and obstetric review. The Trust agreed to explain what it has done to prevent a reoccurrence of these failings.