Loss of Pathology Specimen - Uncertain Diagnosis

63-year-old Mrs S attended the A&E Department with a short history of lower abdominal pain and loss of appetite and was admitted with suspected appendicitis although the possibility of an abdominal tumour was also considered.

The following day an exploratory laparotomy revealed a large mass partially obstructing the bowel and a right hemi-colectomy was performed. A pathology specimen was sent for analysis in order to confirm the nature of the tumour although the surgeon believed it to be cancerous.

Mrs S recovered well from the surgery without any complications and was discharged a week later. Unfortunately the specimen never reached the laboratory, possibly because of inadequate labelling, so it was impossible to know for certain whether or not the tumour was malignant.

However, because of the strong suspicion of malignancy Mrs S was referred to the Oncology Department where she underwent a whole body CT scan. Despite the fact that this revealed no evidence of metastatic disease a 24 week course of adjuvant chemotherapy was commenced. She has remained well and symptom free ever since.

Mrs S found that the uncertainty about whether or not she had had cancer caused her a great deal of anxiety and she became concerned that without a firm diagnosis she may not receive the correct treatment.

The Trust accepted that the loss of the specimen was inexcusable and made an offer of the nominal sum of £2,000 to compensate for the anxiety caused to Mrs S. This was accepted after negotiations in respect of costs.

A provision was included in the settlement for Mrs S to be able to reopen her case in the event that causation could be established. For example, if her health deteriorates in the future and it becomes evident that the lack of information caused by the loss of the pathology specimen prevented a more effective treatment.