WWYD? Hospital "negligence"

QuackQuackOops

Hootie19 wrote: »

First off, let me say, I am NOT interested in sueing - before I get flamed for that!

On 13th August, after experiencing pain, swelling and finding a lump in my calf, on the advice of the OOH doctor, I attended the Urgent Care Centre, to be assessed for a possible DVT.

After seeing three doctors, and having various tests, I was told that the blood tests showed that it was not a DVT, and sent home with a week's worth of two lots of powerful antibiotics. They weren't sure what it was, but mentioned a rather generic "infection", or possible abscess. I was told to go to the GP three days later, whether I thought the antibiotics were working or not.

This I did, and that GP thought it was an abscess. She said that she didn't think that the antibiotics the hospital had given me would be enough to get rid of it, and gave me a prescription for a further week's supply.

At this point, the pain was excruciating and the lower leg was very swollen.

After completing the course of antibiotics from the GP, there stil lhad been no improvement, so I went back and saw a different GP, who then prescribed a 10 day course of the same antibiotics.

After 5 days, I went back (pain pain pain pain) and she then also prescribed anti inflammatories. Maybe coincidental, but within 4 hours of taking the first one, the pain was almost gone and I was walking almost normally.

The swelling did not subside, so after finishing the third lot of antibiotics yesterday, me and my elephant leg (left calf measured 15 inches, right calf measured 18.5 inches, with a similar difference between the ankles), attended a third GP this morning. She wasn't sure, but said she was leaning towards a "something" phlebitis but wasn't ruling out DVT. She gave me prescriptions for more anti inflammatories and diuretics (thank goodness for pre-payment certificates!) and referred me to the DVT Clinic at a local health centre for this afternoon.

I attended there, where they took blood and analysed it there and then. The analysis indicated that treatment should be commenced for a blood clot. I had the first treatment there (an injection into the stomach - I am needle phobic ), and will attend tomorrow for a second dose, with a third dose being administered at home on Sunday by the District Nurse. No plans have been made for the administration of any further doses, as at the moment they are treating it as DVT as a precaution.

I have an appointment at 9.15am on Monday at the Imaging Department at the hospital, where they will scan my leg. The scan will show whether it is in fact a DVT. Further treatment will be decided after the scan has been done.

So finally to the crux of this post!!

Both the GP this morning, and the DVT nurse this afternoon said "but why didn't they scan your leg at the hospital when you first attended"? I'd quite like to know that too.

Would there be any point in taking it up with the phlebotomy department at the hospital, or the doctor(s) I saw there four weeks ago. Or do hospitals have complaints departments? If it does turn out on Monday that it is a DVT, then I have been walking around with a potentially fatal condition that should have been treated a month ago. Fortunately, I've suffered no real ill effects from it, but the "what ifs" are there.

As I said at the beginning of the post (sorry for the length of it) I'm not interested in any financial gain, but I if it does turn out to be a DVT, I would like to know how this could have been missed, and also would like to know what, if anything, they will implement to ensure it doesn't happen again.

Talk about What if's and we can get upset and angry about all kinds of things that never happen or could happen.

When all said and done, doctors wont order every single test going on the basis of a 'What If'. The original findings were that it was not a DVT and they acted accordingly. Sometimes blood tests dont always show whats going on immediately.

Nothing has happened that is untoward but if you feel so strongly that you feel the need to complain then do so, however, a complaint based on why a certain test wasnt done when there is no evidence to suggest that test should have been done is unlikely to produce results that youll be happy with.

kittiej

I had another DVT whilst 8 weeks pg with DS1.

I went to A&E who said they didn't think it was but would send me to the bigger hospital for them to decide. After a few tests they still weren't sure so I had a scan which showed there was indeed a clot. If it hadn't have been for the scan then they wouldn't have been totally sure.

I was then faced with injecting twice a day which was OK when the baby was small but not as we were getting to full term. Very awkward trying to inject with a wriggly baby dancing about

The only thing I would say is that once the vein is damaged it can cause you to have aches and pains.

Good luck, hope you get sorted out soon.

Errata

Both the GP this morning, and the DVT nurse this afternoon said "but why didn't they scan your leg at the hospital when you first attended"? I'd quite like to know that too.

Ask your GP to find out, they should have received correspondence from the hospital with details of presenting symptoms, diagnosis, treatment given and why.

Kaz2904

Did she think it might be Thrombophlebitis?
DVT's can't be seen or felt under the skin and thrombophlebitis is almost never life threatening. http://your-doctor.com/healthinfocenter/medical-conditions/cardiovascular/cardiac-conditions/vascular-dz/dvt.html
http://www.patient.co.uk/health/Phlebitis.htm
I hope it all goes well this morning and look forward to an update
Hope the following links help ease your mind.

scrappie_2

Hootie - I would go the PALS route. They are beyond helpful and will let you know what is happening every step of the way.

The one question I would ask is to see a copy of the Trust's clinical pathway for suspected DVT. If at any time a Dr of the Trust suspected a DVT then this pathway should have been followed. If it wasn't - then it's negligence.

We all understand that hospitals are busy and we expect Dr's to be superhuman and not make errors -unfortunately they are human like the rest of us and does it happens. What is important is that hopefully you will be OK and if it turns out an error was made in the management of your treatment, then it needs to be brought to the attention of the hospital Trust so that they can then put measures in place to try and prevent it happening again.

Hootie19

I attended for an ultrasound scan on my leg this morning, which confirmed that I do have a DVT. I was then sent to the anti-coagulant clinic.

The daily Herparin injections will continue, probably for the rest of this week. These have to be done at the hospital, and so I will have to go there daily for the rest of this week. (At £4 a time for parking, I'll be broke by the end of the week!) Coupled with the Herparin, I am also starting Warfarin, which I will take for 6 months. The injections continue until Warfarin is established and this will be confirmed by daily blood tests (think the nurse said it's a fingerprick thing so nothing too invasive). Once the Warfarin is established, the injections can be stopped, and I will be transferred to the care of my GP.

By the time I came out of the clinic this morning, my head was spinning, and I can't remember if she said that the blood tests will continue beyond the establishment of the Warfarin, or only until then.

Then onto the must/must not dos! Daily activities to continue as normal. Gentle exercise, no contact sports, no alcohol, dark green vegetable intake to be restricted, no Cranberry juice (cranberry sauce is ok though!), any bleeding (nosebleeds etc) which lasts more than 5 minutes to be taken to A&E, any out of the norm bruising (whole arm, whole leg etc) to go to A&E, no anti-inflammatories to be taken.

I have to inform the Rheumatologist that I have a DVT in case this interferes with any of the medication I take for arthritis, and also to speak to my GP about continuing with the HRT that I am taking.

I think that's about the jist of it!

I asked the nurse how it could have been missed on my first visit to the hospital on August 13th. She said she would look at the notes from that hospital visit later today, and will discuss it with me at my appointment tomorrow.

I didn't mention before, which may be relevant, but in terms of DVT indicators, I am overweight, I have a sitting down job, and I am taking HRT. I will wait and see what the nurse tells me about the tests done on my first visit before deciding what to do. Apparently, the three courses of antibiotics I have taken, plus the anti-inflammatories, have been a waste of time. Again - thank goodness for prescription pre-payment certificates. 3 x 2 lots of antibiotics, 2 x anti-inflammatories, then 1 x diruetics (just in case) would have added up to a tidy sum.

meritaten

aww I am really sorry to hear that Hootie.
the only practical advice I have is that if you have to attend the hospital so often can you find out if they can waive the parking fee? some hospitals do this for 'frequent flyers' otherwise would it be cheaper to park elsewhere? and bus in?

Frogletina

It took 11 weeks for my DVT and PE to be diagnosed

I was in a lot of pain, agonising pain and I had to take days off work. I was told it was cellulitis, then phlebitis - and when I got pains in my chest, (like a huge band constricting my lungs) my breathing was tested and I was told I had the lungs of a 19 year old (I was nearly 40) and was told it was Tietze's syndrome.

I eventually was sent to hospital, and after nearly being sent home by the consultant (another story) - I was seen by some students who were collecting case histories.

When the student described my history to his tutor, the tutor manipulated my foot in a particular way and said it was the best way to diagnose thrombosis. It was the last GP who I had seen (out of about 7) who had done this and told me to go home, pack a bag and go straight to hospital.

Heparin and then warfarin sorted me out - but I am left with an ankle and leg which swells, especially in hot weather - and this will never go away.

scrappie_2

Hootie, I'm so sorry to hear that.

hope that you get better soon - whatever you decide to do!