A medical practice in the Dorset area

4. Mrs D complains between May and August 2020, the Practice twice misdiagnosed her urinary and lower abdominal symptoms as cystitis. Mrs D was diagnosed with squamous cell carcinoma (bladder cancer) in August 2020. In February 2021, Mrs D underwent surgery to have her bladder removed. In June 2021, Mrs D was diagnosed with terminal cancer.

5. Mrs D feels the delay in diagnosing her cancer between May and August meant she had to have her bladder removed. She feels this may not have happened if the Practice had identified her cancer symptoms sooner. Her husband, Mr D, had to take unpaid leave to become a full-time carer for Mrs D.

6. By bringing her complaint, Mrs D wants an apology, an explanation of the treatment the Practice provided and compensation for the misdiagnosis of her terminal illness.

7. In May 2020, Mrs D contacted the Practice as she was experiencing pain on urination, and lower abdomen pain.

8. The Practice diagnosed cystitis and provided Mrs D with antibiotics. Cystitis is bladder inflammation, usually caused by an infection.

9. Between 5 May and 27 July, the Practice prescribed eight different antibiotics with no effect on Mrs D’s symptoms. The Practice also prescribed thrush treatments. On 6 July, GP 1 (a General Practitioner at the Practice) confirmed Mrs D had a urinary tract infection (bladder infection) and requested an ultrasound scan.

10. On 27 July, a nurse queried a diagnosis of interstitial cystitis. According to the NHS website, this is a poorly understood bladder condition that causes long term pelvic pain and problems urinating.

11. On 5 August, having not heard from the ultrasound department, Mrs D requested a referral for a private scan. GP 1 completed the referral on 6 August, and on 10 August Mrs D had the ultrasound scan. This revealed a ‘shadow’ on the bladder. On receipt of the report on 11 August, the Practice referred Mrs D to the urology department via a ‘fast-track’ referral.

12. The urology department identified the tumour in Mrs D’s bladder and surgeons removed this in September 2020. Mrs D underwent a course of chemotherapy from November until December 2020.

13. In February 2021, Mrs D underwent surgery for a full bladder removal. Sadly, six to eight weeks later, hospital staff discovered the tumour had returned and spread to Mrs D’s pelvic region.

14. Since then, Mrs D has had radiotherapy, which unfortunately did not improve the tumour. She required a further operation to remove the tumour, but she was not strong enough. Hospital staff gave Mrs D a terminal cancer diagnosis in June 2021.

16. Our organisation can consider complaints about organisations working on behalf of the NHS and whether organisations are responsible for failings. However, the law says we cannot investigate a complaint where a person has (or had) the option to take legal action. That is, unless we consider this is (or was) unreasonable in the circumstances. We have discussed this with Mr D to understand the circumstances and the outcomes he and Mrs D want. We do not consider whether legal action would succeed but whether it would be a reasonable option to look in to.

17. Mrs D complains the Practice repeatedly misdiagnosed her symptoms as urinary tract infections (UTIs) from May to August 2020. She complains the Practice continually provided her with antibiotics for UTIs, which she says did not work. She wonders why the Practice did not refer her for a scan sooner, when the antibiotics did not work.

18. Given the nature of the complaint, we consider whether there is a legal cause in a medical negligence claim against the Practice. Therefore, we need to consider if it is reasonable for Mr and Mrs D to take this route.

19. Mr D told us they want a full explanation as to why it took the Practice so long to refer Mrs D for a scan of her bladder. They feel the Practice made mistakes and they want to know why. They would also like to achieve a financial remedy in recognition of the potential misdiagnoses between May and August. Mr D explained Mrs D has been unable to work for two years and is unlikely to work again. Mr D told us he is currently on unpaid leave from his job to care for Mrs D. He estimated they had lost around £20,000.

20. Mr and Mrs D are looking to achieve a financial remedy amount, which lends itself towards legal action. Mr D did not indicate a specific amount but told us about the loss of £20,000 in earnings. While Mr D indicated they may accept less than this, it may still be beyond the amount we may be able to recommend if we upheld the complaint. However, legal action could possibly achieve this if a solicitor decides to take on the case.

21. In addition, it would be reasonable to expect explanations of the Practice’s care would be a by-product of taking legal action.

22. Overall, we consider Mr and Mrs D do have a legal cause, and this is something they should explore. Therefore, we will not be taking any further action on the complaint at this time.

1. We have carefully considered Mrs D’s complaint about a medical practice in the Dorset area (the Practice). We were very sorry to hear of Mrs D’s diagnosis and the difficult time Mr and Mrs D have and continue to face.

2. We have decided Mrs D could take legal action on the matter she and Mr D have brought to us. We have looked at the complaint in detail and believe there is an alternative legal remedy, in the form of pursing a legal claim, available to Mr and Mrs D. We believe this is the best, and possibly quickest, action for Mr and Mrs D in the circumstances. Therefore, Mr and Mrs D should explore this option further.

3. We will explain our decision in detail below.