“Shocking” medical errors revealed in new report

A BRAIN-damaged baby and failings in cancer diagnoses are among the “shocking” cases dealt with by the Parliamentary and Health Service Ombudsman in England this year.

A new report summarising 161 cases from April to June this year also highlights concerns over patients being discharged unsafely from hospital.

Ombudsman Dame Julie Mellor said the anonymous case summaries “highlight the devastating impact failures in public services can have on the lives of individuals and their families.”

"A shocking case that stood out was that of a one-day-old baby who suffered permanent brain damage at Barts Health NHS Trust in London because a nurse and two doctors made serious mistakes during a blood transfusion.”

She added: "We are increasingly concerned about patients being discharged unsafely from hospital. Unplanned admissions and readmissions are a massive cost to the NHS.”

Another case involved a man cared for by Barking, Havering and Redbridge University Hospitals NHS Trust who died following a liver biopsy. The investigation found he had an inadequate care plan, was incorrectly discharged from A&E and biopsy consent was not properly obtained. He was not properly monitored, cared for and given inappropriate medication after the biopsy, and the Trust lost clinical records.

The report also detailed the treatment of a man who attended a Bedford Hospital NHS Trust A&E with nausea, vomiting and not opening his bowels for three days. The following day he was admitted to hospital where surgery found he had a complete loss of blood supply to his small bowel. The Ombudsman found the Trust inappropriately discharged the man from A&E.

Mistakes were also made in the care of a woman who had surgery at Wirral University Teaching Hospital NHS FT. She was told she had cancer in her stomach and bowel and would need cancer treatment and further tests, but staff did not arrange these. She then saw a surgical consultant who said there was no cancer whatsoever. Five weeks later the surgical consultant told her she did in fact have cancer.

Dame Julie said the case summaries, with a new batch published quarterly, would allow the public to see the different types of complaints handled by her office, along with her findings and recommendations.

“I hope this will give people with concerns about the service they have received the confidence to come to us to complain,” she said. “We also want to provide valuable lessons for public services, and show how complaining makes a positive difference to them."

A Department of Health spokesperson added: "The NHS is the most transparent it has ever been — and we're focusing on confronting poor care like never before. That's why in our response to the Francis Report on Mid Staffs we made it clear that we want the Parliamentary Health Service Ombudsman to investigate more cases so lessons can be learnt and patient care improves.”

Read the case summaries here