A 3 year old girl, Miss R, was taken to A+E by her worried parents. She was examined and kept in overnight as it was noted that she had a high temperature. One of the junior doctors also sent a urine sample to check for infection. The next day, as the patient was much better she was discharged by the Consultant, with the diagnosis being “Likely Viral Illness”.
Unfortunately, the microbiology department had found that there was, in fact, a urinary infection. These results were phoned through to A+E, but never passed onto the Consultant. A day later a formal report arrived, and was signed by a junior doctor, but not acted on.
A month later, Miss R presented to her GP with symptoms of a urinary infection. Another sample was sent, confirming infection and the patient was started on appropriate antibiotic treatment. As the GP thought that this was the first episode of a urinary infection, no further investigations were performed, in accordance with guidelines. A short discharge form from the hospital made no mention of an infection.
2 years later, Miss R presented to A+E again, acutely unwell. At this point, they reviewed the old results on the computer and noted the microbiology test. Scans were then arranged, showing a kidney problem that predisposes a patient to getting urine infections. Unfortunately, by this point, Miss A had suffered severe scarring to her kidneys.
It is important that hospitals and GP surgeries have robust systems in place for checking tests. Legally, it is the responsibility of the ordering doctor to check the result, but this is not always practical – for example, if a doctor has just finished an on-call shift and is not going to be in the hospital again for several days. For this reason, documentation in the notes and a good handover to other staff is essential.
If you feel that you have suffered because of a missed test result, then you may have a claim for medical negligence – we suggest that you call a firm of specialist solicitors to discuss the matter further.
Case source – http://www.medicalprotection.org/uk/education-and-publications/case-reports/missed-test-result