Trust should have carried out further tests that might have shown man's cancer earlier

What happened

Mr G had a number of illnesses, for which different specialists were treating him. He had pain in his left leg which limited his ability to do any exercise so the Trust's pain team saw him.

Doctors gave him some medication and a physiotherapist gave him some exercises to do. An MRI scan showed some changes in his lower spine. Eight months later, his pain had improved and he was discharged from the care of the pain team.

Twenty-one months later, Mr G was again referred to the pain team, but this time his pain was on his right side and was more constant than before. He had also lost weight. A nurse discussed his symptoms with a doctor, who recommended some medication.

Over the next four months, Mr G had different medications but his pain did not improve. He was then seen by a doctor for pain in his shoulder and given further medication. Mr G's pain got worse and another doctor advised that no further tests were needed, but that the Trust could do a lumbar epidural (give pain relief directly into the space outside the sac of fluid that surrounds the spinal cord).

Mr G had this procedure but it did not improve his pain and he was no longer able to get out of bed. Six months after he was first seen with right-sided pain, Mr G went into hospital. His family complained that his notes appeared to recommend that Mr G was discharged before further tests were done. However, Mr G stayed in hospital, and following these and other tests, Trust staff diagnosed him with lung cancer. This had spread to his bones and he died about a month later.

Mrs G and her son said that if Mr G had had another MRI scan, his bone cancer might have been found earlier and he would not have experienced unnecessary pain and suffering. They also said that the Trust's poor handling of their complaint added to their distress. The family were promised an investigation, which never happened, and also a specific apology, which they never received.

What we found

We partly upheld this complaint. There were a number of occasions when a doctor should have seen Mr G, taken his full history and arranged for an MRI scan. This would have shown his cancer earlier, but it never happened. Despite the complexity of Mr G's condition, the Trust left his care to pain nurses to manage.

The way the Trust handled Mrs G and her son's complaint was poor and amounted to maladministration. The Trust gave conflicting information about the promised investigation that did not match the evidence we had seen. There was also no evidence of learning.

However, Mr G's pain management was reasonable and despite the family's concerns, pain nurses didnot recommend that he was discharged from hospital before tests were completed; they were simply making sure that they would continue to see Mr G when he was eventually discharged.

Putting it right

The Trust apologised to Mrs G and her son and paid them £1,250 (to be shared between them) for the failings and the injustice caused to them. The Trust also prepared an action plan to describe how the organisation and individuals involved had learnt from this complaint.