Scots thyroid cancer patient faced ‘unreasonable’ four month delay in diagnosis after biopsy failure



A Scots health board has been ordered to apologize after a patient was forced to wait more than four months for a thyroid cancer diagnosis.

A complaint was lodged against NHS Dumfries and Galloway by the parent of the anonymous person, who later had to undergo surgery.

The lump in their neck was discovered after they had an emergency admission to the Dumfries and Galloway Royal Infirmary with acute tonsillitis.

But medics failed to carry out a needle biopsy of the suspicious mass – instead cutting it out around four months later.

The hospital was also found to have failed to tell the patient about nodules that were discovered in their lung.

The Scottish Public Services Ombudsman has found that there was an “unreasonable delay” in diagnosis and ordered a formal apology by the NHS board.

In a ruling, where the patient is referred to as A, the SPSO said: “A had an emergency admission to Dumfries and Galloway Royal Infirmary with acute tonsillitis and a lump was found on their neck.

“This lump was subsequently excised four months later, and cancer was diagnosed the following month.

“C complained that no prior indication had been given that cancer was suspected, and that the delay in diagnosing this led to unnecessary operations.

“They also complained about a subsequent delay in informing them about identified nodules on A’s lung that were being monitored.

“The board told us that they recognized that an earlier biopsy could have led directly to definitive surgery, without the need for further investigations or procedures and ultimately to a quicker resolution for A.

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“They confirmed that they developed a new neck lump clinic as a result of this complaint. We took independent advice from a head and neck surgeon.

“We noted that A should have had an urgent biopsy needle at an earlier point in time. This would have led to an earlier diagnosis and less surgery.

“We noted that an excision should only have been considered if a diagnosis was not possible from the needle biopsy.

“Therefore, we upheld the complaint that there was an unreasonable delay in diagnosing A’s cancer.

“We considered that the new neck lump clinic was the best way to avoid this happening again.

“While we were assured that the delay did not have an impact on A’s prognosis, we noted that it will have added to the distress for A and the family.”

They added: “In relation to C’s concerns about not being advised sooner that cancer was suspected, we noted that cancer did not appear to have been considered earlier.

“We were, therefore, unable to conclude that there was a failure to communicate a suspicion of cancer.

“We noted that the board had already acknowledged that they did not make A aware of the lung nodules when they were identified.

“Therefore, on balance, we upheld the complaint that communication was unreasonable. “The board had already apologized for this and they told us that they had revised their process to require clinicians to copy GP letters to patients.”

NHS Dumfries and Galloway have been contacted for comment.

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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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