Medical negligence can arise when symptoms are not properly recognised, investigated or acted upon. One form this can take is where concerns are dismissed or attributed to less serious causes without appropriate assessment.

This is sometimes described as medical gaslighting. It can occur when a doctor, nurse or other healthcare professional does not fully consider a person’s symptoms, or relies on assumptions rather than carrying out the necessary tests or referrals.

While this, of course, is not intentional in the majority of cases, the consequences can be serious. It is also undeniable that most medical professionals are motivated to assist and support patients and do so.

However, when symptoms are not taken into account, diagnosis can be delayed and conditions may worsen. In some cases, people are left managing significant pain or distress without clear answers. There can also be a psychological impact, particularly where individuals feel their concerns have not been acknowledged or understood.

The following case studies highlight how these situations can develop in practice. They show how missed opportunities to investigate symptoms can lead to avoidable harm, and why it is important that concerns are properly assessed at every stage.

Case Study 1: “I Thought I Was Going to Die” - A Missed Ectopic Pregnancy

When ‘Sarah’ began experiencing sudden and severe abdominal pain, she went to hospital for urgent medical attention. Blood tests were carried out, and she was told that she was pregnant and likely experiencing a miscarriage. This came as a shock, as she had been unaware of the pregnancy, but she was sent home and advised to allow the miscarriage to progress naturally.

However, ‘Sarah’s’ condition did not improve. The pain became overwhelming. Her abdomen was severely bloated, and she was unable to sleep, eat or sit still. She later described feeling as though she “thought she was going to die”.

The following day, she returned to A&E at the same hospital. This time, her symptoms were taken more seriously, and she was referred to the gynaecology unit. A transvaginal scan and ultrasound scan were carried out, which confirmed that she had an ectopic pregnancy. By this stage, there was already significant internal bleeding and her fallopian tube had ruptured, and ‘Sarah’ ultimately required emergency surgery to remove her right fallopian tube.

Looking back, earlier investigation during her first hospital visit could have identified the ectopic pregnancy before it reached this stage. This would have reduced the extent of the harm she experienced.

Since the surgery, ‘Sarah’ has continued to experience pain on the right side of her abdomen. Despite returning to hospital on multiple occasions, her concerns have been attributed to post-surgical pain, leaving her without clear answers or further investigation.

Case Study 2: “You’re Not in Enough Pain” - When Symptoms Are Not Taken Seriously

When ‘Kate’ began experiencing severe abdominal pain, she attended an urgent face-to-face appointment with her GP. At the time, her periods were irregular due to the contraceptive coil. During the appointment, the GP took her temperature and examined her abdomen, concluding that she likely had a kidney infection. She was prescribed antibiotics, and no further discussion took place about her menstrual cycle or the possibility of pregnancy.

Over the following days, ‘Kate’s’ condition worsened. She woke to find she was bleeding heavily, which she initially believed to be her period. However, the pain intensified significantly later that day, prompting her to attend A&E.

At hospital, she explained her symptoms and the GP’s earlier diagnosis. A urine sample was taken, which confirmed that she was pregnant. She was advised that she would need to wait for a scan to determine whether this was an ectopic pregnancy.

Despite this, an internal examination by the gynaecology team led to her concerns being dismissed. She was told that it was unlikely to be an ectopic pregnancy because, in their view, she would have been in more pain during the examination. As ‘Kate’ recalls, she was told: “I don’t think you’re screaming in pain enough for it to be an ectopic pregnancy.”

She was sent home.

The pain became so severe that ‘Kate’ struggled to stand. When she contacted the hospital again, she was advised that nothing further could be done until her scheduled scan, and that it could be a miscarriage.

Two days later, she returned to hospital in a visibly deteriorated condition. This time, doctors recognised the seriousness of her symptoms immediately. A scan confirmed an ectopic pregnancy with significant internal bleeding. By this stage, the condition had progressed too far to be treated with medication, and she required surgery to remove her right fallopian tube.

Earlier consideration of her symptoms, including appropriate investigation at the GP appointment or during her initial hospital visit, would have led to her being able to get treatment with methotrexate, rather than undergoing surgery, to manage the ectopic pregnancy. 

Following her treatment, ‘Kate’ did not receive clear guidance about the potential impact on her fertility or what support might be available to her. This added to the distress of an already serious and traumatic experience.

Case Study 3: “I Was Told It Was Normal” - Missed Cauda Equina Syndrome

Following a gym injury, ‘Michael’, 33, began experiencing persistent lower back and leg pain. Despite attending physiotherapy and seeking medical advice, his symptoms did not improve. As the pain continued, he underwent lumbar fusion and discectomy surgery.

During the procedure, a complication occurred, but it was addressed at the time. However, in the days following the operation, important neurological checks were not carried out or properly recorded. When ‘Michael’ reported new symptoms, including saddle numbness, his concerns were not escalated.

As his condition worsened, these symptoms were not treated as urgent warning signs. Instead, he was reassured that what he was experiencing was normal following surgery and would settle over time.

It was only when he was referred for a second opinion that his concerns were validated and an MRI scan was carried out, revealing that he had developed cauda equina syndrome. Urgent decompression surgery was performed, but by this stage, the opportunity to prevent long-term damage had passed.

‘Michael’ was left with permanent bladder, bowel and sexual dysfunction, alongside ongoing pain. The impact on his daily life was significant, and he also experienced psychological distress as a result of his condition.

Further investigation identified multiple failures in his care. Appropriate neurological observations after surgery would have led to earlier imaging and intervention. In turn, this is likely to have prevented the severity of the long-term effects.

In addition, alternative, less invasive treatment options were not fully considered or discussed with ‘Michael’ before his initial surgery.

You can read ‘Michael’s’ full story by taking a look at the complete case study:

https://www.jmw.co.uk/success-stories/cauda-equina/several-failures-leave-man-with-ces

What Are the Common Patterns Behind These Stories?

While each of these stories is different, there are clear and consistent themes that run through them.

Across these cases, concerns were not always fully explored, and important opportunities to investigate symptoms were missed. This can happen in a number of ways:

• Symptoms are attributed to less serious causes without thorough investigation: In each case, initial explanations were given without carrying out all appropriate tests or considering alternative diagnoses.
• Concerns are dismissed or minimised: People clearly described severe or worsening symptoms, but these were not always recognised as potential warning signs of a more serious condition.
• Assumptions influence clinical decisions: Decisions were sometimes based on expectations, such as how much pain someone “should” be in, rather than a full clinical assessment.
• Repeated attempts to seek help are not escalated: Returning to hospital, contacting services again, or reporting new symptoms did not always lead to further investigation or urgent review.
• Delays lead to more serious outcomes: As these cases show, delays in diagnosis can result in conditions progressing, requiring more invasive treatment or leading to long-term complications.

There can also be a psychological impact. When concerns are not acknowledged, people may begin to question their own judgement or feel uncertain about seeking further medical help. This can affect confidence in healthcare professionals and lead to ongoing distress.

It is important to recognise that not every missed diagnosis will amount to medical negligence. However, where care falls below a reasonable standard, and this leads to avoidable harm, there may be grounds to investigate a medical negligence claim.

What You Can Do If You Feel You Are Being Ignored

If you feel that your symptoms are not being taken seriously, there are practical steps you can take to ensure your concerns are clearly recorded and properly considered. This is not about challenging healthcare professionals, but about making sure your symptoms are fully assessed. Clear communication and patients advocating for themselves will help further ensure concerns are discussed and addressed.

• Keep a clear record of your symptoms: Write down when your symptoms started, how they have changed, and how they affect your daily life. This can help a GP, nurse or consultant understand the full picture.
• Make a note of appointments and advice given: Recording what was discussed during appointments, including any diagnoses or reassurances, can be useful if your condition does not improve.
• Ask direct questions: If you are unsure about a diagnosis, it is reasonable to ask whether further tests are needed or if there could be another explanation for your symptoms.
• Explain if your symptoms are getting worse: Make it clear if there has been a change in your condition, particularly if the pain is increasing or new symptoms have developed.
• Seek a second opinion: If you remain concerned, you can ask to see another GP or request a referral to a specialist. The Patient Association provides guidance on this.
• Bring someone with you to appointments: A friend or family member can help you explain your symptoms, ask questions, and confirm important information is not overlooked.

Taking these steps can help ensure that your concerns are clearly communicated and that appropriate decisions are made about your care. Find out more by taking a look at our guide on how to respond if you think you are being gaslit by a doctor.

Where Can I Seek Support?

If you believe your concerns have not been taken seriously, there are organisations that can offer guidance, help you raise concerns, and support you in understanding your rights.

• The Patients Association provides free, independent advice for people navigating healthcare concerns. They offer support on how to raise issues, understand your rights, and communicate effectively with healthcare providers.
• If you want to raise a formal concern about your care, the NHS sets out a clear complaints procedure. This allows you to have your experience reviewed and responded to by the organisation involved.
• Action against Medical Accidents (AvMA) is a UK charity specialising in patient safety and medical negligence. They provide independent advice on whether your experience may involve substandard care and what steps you can take.
• Healthwatch gathers feedback about health and social care services and can guide you on how to make your voice heard. They also provide information about local services and patient rights.
• If you are not satisfied with the outcome of an NHS complaint, the Parliamentary and Health Service Ombudsman can carry out an independent review. This provides an additional level of accountability where concerns remain unresolved.

Alongside these organisations, speaking to a specialist medical negligence solicitor can help you understand whether your experience may amount to medical negligence and what your next steps could be.

At JMW, we support people who have experienced medical negligence by carefully investigating what happened and providing clear, practical advice. We take the time to understand your experience, review your medical records, and work with independent experts to assess whether your care met a reasonable standard.