‘Human error’ led to three-month delay for cancer treatment

NHS Highland has been warned after a lung cancer patient was misdiagnosed and treatment was delayed for three months.

The Scottish Public Services Ombudsman (SPSO) said NHS Highland was at fault after the patient complained about the way in which they were treated by the health board.

The SPSO said it has asked the board to make sure it has met its obligations in being honest and transparent with patients under a principle known as “duty of candour”.

NHS Highland received the complaint from an advocate, referred to in a report as “C”. The patient was referred to as “A”.

The report stated: “A had attended the board for a chest X-ray following respiratory symptoms but the X-ray was reported as normal.

“A had a second chest X-ray a few months later which led to them being diagnosed with lung cancer.

“On review of the first chest X-ray it was found that this had been abnormal and was reported incorrectly.”

C complained to NHS Highland. The health board recognised a mistake had been made through the reporting radiologist.

The board apologised to A. At the same time it confirmed the misdiagnosis met the criteria for duty of candour.

An internal review at NHS Highland found it was “human error” and it was not considered to be indicative of a wider problem within the organisation.

The SPSO report said: “We took independent advice from a lung cancer physician.

“We confirmed that A’s diagnosis of lung cancer had been delayed by around three months due to the first chest X-ray being incorrectly reported.

“We found that it was reasonable for A to have expected the abnormality in their chest X-ray to be identified.”

SPSO made no further recommendations.

C also complained about the board’s handling of their complaint, which was upheld.

An NHS Highland spokeswoman said: “We are reviewing our duty of candour arrangements and will be updating the SPSO by end of June.”