Patient had procedure that was not necessary and that he had not consented to

What happened

Mr J had been treated with internal radiotherapy for prostate cancer. In 2013 he had a colonoscopy, an examination of the inside of the colon, as part of the NHS bowel cancer screening programme. During the colonoscopy, doctors found that Mr J had radiation telangiectasia (small widened blood vessels caused by the radiotherapy). They cauterised the area using a process called argon plasma coagulation (APC), a controlled burning of the superficial tissue. Mr J said this treatment was inappropriate and that it was carried out without discussion or his consent.

Mr J experienced severe pain and bowel problems for a year after the procedure was carried out. Doctors subsequently found that Mr J had a complication of APC, and he had two months of therapy using oxygen to treat this. The treatment took place for five days a week over a period of two months and was carried out at a hospital approximately 100 miles from Mr J's home.

While the treatment was successful, this was a very stressful time for Mr J and he incurred significant costs, including accommodation and travel expenses.

What we found

There was a failure to get Mr J's informed consent for the APC procedure. In addition, the information available to the consultant at the time did not support the use of APC in Mr J's case.

As a result of these failings, Mr J was denied the opportunity to make a fully informed decision about his treatment. APC was an inappropriate procedure for him, and it caused his subsequent bowel problems and the associated pain. He suffered distress and financial costs in having to have oxygen therapy to treat this.

The Trust had taken appropriate action to learn from the failings we had identified. The consultant gastroenterologist who had carried out Mr J's procedure had discussed the case with colleagues, and reviewed published literature on the subject. In addition, the Trust issued a circular to relevant medical staff advising that any heat therapy such as APC should not be routinely used on radiation induced gastrointestinal disease.  However, we found that the Trust had not done anything to address the personal injustice it had caused Mr J.

Putting it right

The Trust wrote to Mr J to acknowledge the failings and apologise to him for the impact this had on him. It also paid Mr J £4,000 to cover the cost of accommodation, travel and other associated expenses he incurred while having the oxygen treatment.