Thornton v Homerton University Hospital NHS Trust [2017] EWHC 3244 (QB) (15 December 2017)

On 21 December 2012 WT then aged 74 died from oesophageal cancer. (paragraph 1)

This claim for damages is brought in respect of treatment given to WT by the Emergency Department… on 9 January 2012. On that day WT had attended the hospital with a food bolus lodged in his throat. The bolus had been lodged for some time reported as being approximately 18 hours. It is common ground that the bolus cleared during the course of his attendance and whilst awaiting an appointment with a doctor and in any event prior to him being seen by D. Following a consultation involving the taking of a medical history, an assessment of the presenting problems, an examination and discussion of treatment options WT was discharged without any recommendation for further investigation but with what has been described, at least in this litigation, as ‘safety net’ advice to return to the Emergency Department if WT felt unwell or if he was unable to tolerate fluids or food. (paragraph 2)

WT did not return to D for any further appointment. (paragraph 3)

In July 2012 WT attended upon his GP with a one month history of vomiting and weight loss. He was referred back to D for an upper gastrointestinal (GI) assessment. In mid-August 2012 WT underwent an endoscopy and was diagnosed with oesophageal cancer. It is now alleged that D was negligent in his management of WT’s admission on 9 January 2012. It is said that WT should not have been discharged without specific advice to pursue further investigation. It is alleged that such further investigation would have led to an earlier diagnosis of the malignancy. It is further alleged that this negligent management was responsible for a delay in the diagnosis and treatment of WT’s disease. (paragraph 4)

[dispute of fact: that WT alleged he had reported difficulty swallowing in 2011 – court found D was not told of any history of swallowing difficulties. (paragraph 52)]

..there is no golden rule that sets a mandatory requirement for a referral for further investigation following what is believed to be a first presentation with a food bolus obstruction, particularly where, as in the present case, the same has cleared without medical intervention. (paragraph 86)

Claim dismissed