‘Mark’, 22

Mark, a plasterer, was referred urgently to hospital after experiencing worsening stomach pains and weight loss. Although doctors considered Crohn’s disease as a possible diagnosis, a barium meal examination was incorrectly reported as normal.

Mark continued to experience gastrointestinal symptoms for more than a year before another consultant reviewed the original examination and identified an abnormality consistent with Crohn’s disease.

JMW investigated the delay in diagnosis and secured £18,000 compensation for Mark.

Hospital Referral

Mark attended his GP complaining of stomach pains after eating. The pain had become increasingly severe during the previous two months and he had also experienced weight loss.

His GP referred him to hospital as a matter of urgency.

Mark underwent a gastroscopy and doctors made a differential diagnosis of coeliac disease or Crohn’s disease. A week later, he experienced sudden, severe epigastric pain and vomiting and was readmitted to hospital.

Missed Crohn’s Disease

Two weeks later, Mark underwent a barium meal and follow-through examination, which was interpreted as showing normal appearances.

Mark’s consultant subsequently wrote to his GP, noting that the barium follow-through examination and duodenal biopsy showed no changes specific to Crohn’s disease.

The consultant noted that the final diagnosis was uncertain, but that Crohn’s disease could not be completely excluded.

During the following months, Mark continued to attend his GP with gastrointestinal symptoms.

Six months later, because of his ongoing ill health, the gastroenterologist arranged for Mark to undergo a white cell scan. The isotope scan produced an abnormal result that suggested Crohn’s disease. Mark started taking a medication called Pentasa.

Getting a Second Opinion

As his symptoms continued, Mark asked for a second opinion.

Mark was referred to a locum gastroenterologist, who saw him just over 12 months after his initial referral to hospital. The consultant started Mark on Prednisolone.

The locum consultant advised that it would be best to treat Mark for presumed Crohn’s disease affecting the small intestine.

The consultant also reviewed the earlier barium meal study and identified an abnormality in the terminal ileum that was consistent with Crohn’s disease. This abnormality had not been reported when the examination was first reviewed.

Mark continued taking Prednisolone and subsequently started treatment with Azathioprine. His condition improved to the extent that he was able to return to work.

How JMW Helped

JMW’s Eddie Jones successfully made the case that the hospital had incorrectly interpreted the barium meal examination.

Had the examination been reported correctly, doctors would have diagnosed Mark’s Crohn’s disease sooner and started more effective treatment, such as oral steroids or, if required, surgery.

The hospital admitted that the care Mark received was negligent. JMW secured £18,000 compensation for his pain, suffering and loss of amenity.