Is this a case for negligence?

LadyL2013

There's no way of making this story short so bear with me.

He had a clean bill of health and a routine blood test in the middle of the year as he is 11 so was advised to do one just as he's a bit older now. This all came back clear, no issues.

Our cat started limping before Christmas, gave him 24 hours because you know how pets can be and they can be fine by the next day. Took him to vets. Vet sedated him in order to properly examine his leg and take an X-ray. Was told the X-ray showed no injuries and he said he gave a thorough leg exam and couldn't find anything so suspected a pulled muscle or ligament damage and gave him painkillers (Metacam). He did not go outside at all between him first limping and him dying.

Didn't get better so took him back a further 2 times to see same vet. Each time he fully examined the leg. Couldn't find anything. From the first appointment to the third was 3 weeks. I expressed concern that he had now been on Metacam for 3 weeks now and we are experienced cat owners and have had it prescribed for a few days here and there in the past with various cats but we had always been told it shouldn't be prescribed for more than a week without blood tests due to risk of kidney damage. I was told it was fine and many cats could take it for years without issue.

5 days later his leg ruptured in what we realised was an abscess. We hadn't spotted it because it was on the inside of his leg and he'd been holding it to him ever since he started limping and wouldn't let us look, but we had trusted the vet had properly examined the leg. Had to take him to the emergency vet as it was late at night. She said it was one of the worst abscesses she had ever seen and it transpired had been caused by a very nasty and deep cat bite down to the bone. She couldn't fathom how it hadn't been found. He had a very bad infection and was given double dose antibiotics to add to the painkillers to flush it out.

2 days later took back to the same vet for a check up and again he fully examined the leg, said it looks like it was a bite all along but could offer no explanation as to how the bite had not been found or the abscess had gone unnoticed. He advised a final check up in 7 days. I let him know the antibiotics were giving him horrendous diarrhoea (constantly leaking out of him) and I was worried he was becoming malnourished as his appetite was also reduced due to being in pain. Again I was told it was fine.

Took back in 7 days and saw the head vet this time. Immediately she looked quite concerned and said she though he had a broken leg as she could clearly feel instability and grinding. She re-did x-rays as she felt the set done by the first vet were inconclusive and these found quite a bad dislocation. So obviously he had been attacked by another cat and he had dislocated his leg trying to escape. I asked how this could have been missed by the previous vet when he had examined him 4 times but she couldn't really offer any explanation as she wasn't in the examination, which is fair I suppose. I also asked her if she could please do a blood test as I was worried with the length of time the infection had gone undetected, the prolonged use of Metacam and the side effects of the antibiotics. I could just tell he was more unwell than being in pain.

I'm glad I did because his kidney values were really concerning and he was now severely anaemic and they immediately started him on fluid therapy and ceased the medication immediately. After 3 days his values returned to normal and he was cleared to be discharged and was awaiting his specialist appointment in a few days time to have surgery.

3 days later, we took him to the specialist. He was very concerned about how a dislocated leg had effectively been missed for a month and 4 exams and how bad the abscess had gotten. He asked if he could re-do the bloods just to check they had remained stable. This is when he delivered the hammer blow that he was in the end stage kidney failure and his other organs had started to shut down. He said he had a few days at best but advised euthanasia. We were absolutely devastated and took him home to PTS in his own home. The vet who came (not associated with his normal vets) couldn't believe he was so terminally ill as he said he was in beautiful condition.

I had a long debrief with the head vet the next day. She looked and sounded genuinely gutted and shocked that he had died. She agreed that something had gone horribly wrong and felt it was a combination of delay in finding the dislocation, the abscess and infection going undetected which likely caused organ damage which then meant his body was unable to cope with the painkillers and antibiotics and has essentially caused his body to shut down. However, she was keen to say, there may have been valid reasons why the dislocation was repeatedly missed and it was likely also really bad luck as to how it ended in him dying. She did accept that the delay in finding the dislocation was a large contributing factor but couldn't say if he would have died anyway. I am of the belief if his dislocation would have been found first time, he would have had his operation within a few days and that would have been it. 

I have no issues with the second vet, she did everything she could as soon as she found the dislocation but said in hindsight it was probably already too late at that point as from her finding it to him having to be PTS was 6 days. The injury going undetected for a month had already caused irreversible damage. I asked her if I could make a formal complaint against the first vet. She said I could but in all likelihood, it would come back to her to review as head vet and she wouldn't really be able to tell me any more than what she had already told me on the phone. She said they just can't say for sure it would have made any difference if it had been found straight away.

Based on what the specialist said and the fact she said it was almost certainly a contributing factor, I just fail to believe he would have died if it had been found when it should have been.

I have spoken to the Vet Mediation Service who've said they won't do anything unless I make a formal complaint and that's not resolved to my satisfaction first. So I'm thinking of sending the formal complaint, but really think they'll give me the same answer as the head vet did. It's not about the money (it cost a lot even with insurance!) but the fact that he had suffer with a dislocated leg and infection for so long and that I fully believe he would still be here. We loved him more than anything, his death has devastated us and we know he was a healthy cat just a couple of months before this. It feels like something has gone horribly wrong. I don't think the RCVS would touch it as they think they pretty much only deal with vets actively harming animals or other conduct issues.

I just wondered if people had any advice or feel there is a case to take this further?

TBagpuss

I think you need to think about what you want to achieve.

Do you want a formal apology?
Do you want them to reimburse you for the fees for the extra visits / for the consultant?
Do you want an explanation as to why your concerns about the Metacam and the reaction to the antibiotics were not addressed?

If you make a complaint then it's generally helpful to set out very specifically what you think was wrong - e.g. rather than a narrative, set out bullet points e.g.

• Despite the cat being sedated to allow a thorough examination , the vet failed to notice a severe bite / abscess
• I raised specific concerns about the risk to him of taking Metacam over a long period , these were dismissed and blood tests were carried out, I believe that this was the direct cause of his kidney failure and could have been prevented

Then set out what, specifically, you want them to do to remedy the situation. (e.g. apology / refund / compensation 0

Nothing can bring your cat back.

It's fairly common in any situation where you are making a complaint that you are expected t go through the normal complaints process before being able to access external schemes such as an ombudsman or mediation service

TripleH

LadyL2013, I'm sorry for your loss.

I have nothing more to add, TBagpuss has presented a good explanation above.

LadyL2013

TBagpuss said:

I think you need to think about what you want to achieve.

Do you want a formal apology?
Do you want them to reimburse you for the fees for the extra visits / for the consultant?
Do you want an explanation as to why your concerns about the Metacam and the reaction to the antibiotics were not addressed?

If you make a complaint then it's generally helpful to set out very specifically what you think was wrong - e.g. rather than a narrative, set out bullet points e.g.

• Despite the cat being sedated to allow a thorough examination , the vet failed to notice a severe bite / abscess
• I raised specific concerns about the risk to him of taking Metacam over a long period , these were dismissed and blood tests were carried out, I believe that this was the direct cause of his kidney failure and could have been prevented

Then set out what, specifically, you want them to do to remedy the situation. (e.g. apology / refund / compensation 0

Nothing can bring your cat back.

It's fairly common in any situation where you are making a complaint that you are expected t go through the normal complaints process before being able to access external schemes such as an ombudsman or mediation service

Thankyou.

This is what I have asked myself.

I guess I'd want to know what you said. I'm not bothered about the money. I know nothing will bring him back. I just don't want this to happen to anyone else.

zebedee818

Vets should be held to account. Our elderly cat was limping too and the young vet told us it was arthritis. Turned out to be a tumour; by the time this was formally diagnosed by another vet (same firm), it was too late and she had to be put down. 

lincroft1710

LadyL2013 said:

TBagpuss said:

I think you need to think about what you want to achieve.

Do you want a formal apology?
Do you want them to reimburse you for the fees for the extra visits / for the consultant?
Do you want an explanation as to why your concerns about the Metacam and the reaction to the antibiotics were not addressed?

If you make a complaint then it's generally helpful to set out very specifically what you think was wrong - e.g. rather than a narrative, set out bullet points e.g.

• Despite the cat being sedated to allow a thorough examination , the vet failed to notice a severe bite / abscess
• I raised specific concerns about the risk to him of taking Metacam over a long period , these were dismissed and blood tests were carried out, I believe that this was the direct cause of his kidney failure and could have been prevented

Then set out what, specifically, you want them to do to remedy the situation. (e.g. apology / refund / compensation 0

Nothing can bring your cat back.

It's fairly common in any situation where you are making a complaint that you are expected t go through the normal complaints process before being able to access external schemes such as an ombudsman or mediation service

 I'm not bothered about the money. I know nothing will bring him back. I just don't want this to happen to anyone else.

The one thing that can never be guaranteed is that it will never happen to anyone else. There was a huge thread on here last year about a dog which had had apparently less than satisfactory veterinary care, but apart from causing the dog's owner extended grief being stonewalled by the vets and RCVS I don't think it got anywhere.


Realistically the best you can hope for is an acknowledgement of less than satisfactory veterinary care and a refund of relevant fees.

lincroft1710

Have just realised that this thread was started over 2 months ago, so wonder if there is any update?

elsien

They haven’t logged back in again since March, so probably not.