Summary
Ms C's daughter (Miss A) was diagnosed with throat cancer and was admitted to hospital for chemotherapy and radiotherapy. She was found to have chest and urinary infections, so her chemotherapy and radiotherapy were postponed until these were treated. When her condition improved, Miss A received chemotherapy. After a second course of chemotherapy, she became neutropenic (the blood cells that fight infection had reduced) and was taken to another hospital, where she died.
Ms C complained that her daughter's condition was not properly monitored. In particular, she noted that blood tests were not taken daily, as had happened with another family member with cancer. Ms C felt that, had Miss A's blood results been closely monitored, she could have been treated and her prognosis might have been better. Ms C also complained about staff communication with the family. She was told after Miss A's death that the tumour was one of the largest the consultant had seen. She said that had she known this earlier, she might have decided to keep Miss A at home during her final days.
We took independent advice from one of our medical advisers, who confirmed that blood tests are not carried out daily following chemotherapy. This is because it will already be known that the treatment makes the patient neutropenic. Neutropenia is only an issue if the patient develops sepsis (a severe blood or tissue infection), and this is not diagnosed through blood tests, but from the patient's physical symptoms. If there is evidence of sepsis, then blood tests would be carried out. We found that Miss As treatment and monitoring was in line with the board's protocol for treating patients with head and neck cancers.
The evidence also suggested that communication with the family was good, although we were unable to establish whether specific information was provided about the size of the tumour. It was, however, clear from the records that both Miss A and her sister were told the tumour was extensive; and that Miss A continued with hospital treatment in full knowledge of this.
Related reading
View Decision Report 201004683 as a PDF (11.71 KB) Updated: March 13, 2018