Decision Report 201703280

Summary

Mr C complained on behalf of his late wife (Mrs A) who was diagnosed with cholangiocarcinoma (CCA, a very rare cancer of the bile duct) at Ninewells Hospital. Mr C was concerned that there had been a delay in providing the diagnosis and that, had appropriate tests and investigations been carried out sooner, Mrs A's death may have been avoided. Mr C was also concerned that after diagnosis, the board failed to make further more timely investigations about the spread of the disease (particularly to her bones) for which treatment may have been available. Mr C complained to the board who told him that Mrs A's illness had been life limiting but that throughout her illness, her treatment had been reasonable and appropriate. Mr C was unhappy with this response and brought his complaint to us.

We took independent advice from a consultant oncologist (a doctor who specialises in cancer treatment). We found that Mrs A's illness was very rare and diagnosis was not obvious; it was often an unexpected finding on a scan. Mrs A had stomach problems a few years before her cancer diagnosis, for which she received appropriate tests and at that time there was no evidence that she had cancer. Mrs A had no further stomach problems for two years until she was sent to hospital for a scan and it was at this time that she was diagnosed with CCA. We found that there had been no delay in diagnosis. After her diagnosis, Mrs A was given palliative chemotherapy (cancer treatment that is not designed to cure the disease, but rather prolong life and minimise symptoms) and responded well. Her symptoms were managed as it was not possible to operate, however, Mrs A was later admitted to hospital as she had become jaundiced (where the skin and/or eyes become yellow in colour). Her disease had progressed and was later found in her bones but we did not find that there had been any missed opportunities for treatment that would have changed Mrs A's outcome. We found that her care and treatment had been reasonable. Therefore, we did not uphold Mr C's complaint.