Healthy lung removed by mistake

By ROSALIND GRIFFITHS

A MAN who had a lung removed by surgeons in Aberdeen after a mistaken cancer diagnosis is claiming compensation from NHS Grampian.

Former firefighter Laurie Ball, 58, from Mossbank, was told shortly after the operation that he did not have cancer, but he said that he has had neither an explanation nor an apology from the health board for an action which has ruined his life.

Six months after the operation Mr Ball had a second crisis when his remaining lung collapsed. His wife Cindy just managed to get him to the Gilbert Bain Hospital in time for quick thinking doctors to save his life.

Mr Ball said he had “lost everything” – his job, his health and the prospect of a happy retirement – since having the operation to remove his lung in August 2005.

In May of that year, Mr Ball, then a firefighter at Sullom Voe Terminal, had chest pains and was prescribed antibiotics by his GP. When these did not work he was sent for an X-ray, and later recalled to the health centre.

“I could tell by the doctor’s demeanour it was bad news. He said he was almost sure it was cancer. My wife and I were both shocked.”

Former smoker Mr Ball then went to Aberdeen Royal Infirmary for a CT scan and a bronchoscopy, which collected cells in “washings and brushings” from the left lung. The CT scan apparently confirmed to radiologists that there was a tumour in the lung’s upper lobe, and a pathologist who studied the cells for abnormality also concluded they were “non small cancer cells”, a common type of lung cancer.

Mr Ball said: “They came to a diagnosis that was wrong. But it was enough for the surgeon to take the lung out. They told me so definitely that it was cancer, it was black and white. I believed them 100 per cent.”

However, just days after the seven-hour operation, doctors told Mr Ball there was no malignancy in the lung and he would not need chemotherapy or radio therapy.

Mr Ball said: “At first I was just exhilarated to be alive. I was told I didn’t have cancer but it didn’t register. But after a while I began to get frustrated because no-one could tell me why my lung had to be removed.

“When I got home I read the medical notes that I had been given to hand over to my employers BP with a view to being medically retired. The notes said ‘no malignancy found’ and this was underlined. It was then I decided to claim compensation. I contacted solicitors who would work on a no win no fee basis and they told me I had a strong case.”

What had been diagnosed as cancer turned out to be scar tissue from an infection, the cells of which doctors said were almost indistinguishable from cancer cells. During the operation this tissue was found throughout the lung, which was why the whole lung was removed.

Mr Ball believes the strain of this operation was directly responsible for the collapse and rupture of his remaining lung, a condition known as pneumothorax, which nearly claimed his life in February 2006, and he remains profoundly grateful to the Gilbert Bain team for saving his life. He knows now the pneumothorax, which required a second operation in Aberdeen, was a possible complication after a lung is removed, but was not told at the time.

Following the pneumothorax doctors told Mr Ball he can no longer travel by plane because of the change of air pressure. He is now registered disabled.

He was eventually medically retired in 2006 and thanks BP for keeping him on their books for nearly a year after he stopped work.

Mr Ball, who is originally from Essex and has been in Shetland since 1983, had always prided himself on his fitness and said he was one of the strongest firemen at Sullom Voe. He had been involved in running, sub-aqua diving and weight-lifting: “I felt an obligation to keep myself fit because I was a firefighter.”

He had once rescued an unconscious man from beneath a jetty at Sullom Voe, carried him up a 20 foot vertical ladder and resuscitated him, for which he got a letter of commendation from BP.

But now the father of four grown-up children says: “I can’t do any of the things I used to do, although I’m grateful to family and friends for their help. I’ve suffered a massive deterioration of my health and a huge financial loss through losing my job.”

Simple tasks leave him breathless and he can no longer work on his house – he completely refurbished the family home, working on the roof and putting in new windows – but now “I have to get people in. I can’t even hang a sheet of wallpaper.

“My wife and family have been robbed. We are suffering the consequences of an error made by other people – we’re paying for it.”

Mrs Ball, who does four part-time jobs to keep the family going, said: “There are no words to describe it. Our life has changed dramatically. He can’t do anything he used to do. He stays at home and watches the telly. He can’t even pick his grandchildren up. He’s in pain and has to take morphine twice a day.

“I just want the medical team to say they’ve made a mistake and for the health board to share the financial consequences. They’ve taken five years of Laurie’s working life. He was building up to retirement and it’s been snatched away.”

Mr Ball said that NHS Grampian must be culpable because his medical team acted in error, relying too much, he feels, on the findings of one pathologist.

“If pathology is a judgement call, not an exact science, why aren’t more pathologists involved? Why is all that responsibility on one person? Even if no one individual is guilty of incompetence or negligence, I still believe I have a valid and legitimate claim for the error.

“It would be intolerable if they [the health board] are able to walk away after a horrendous blunder that removes a person’s health and quality of life without bearing any consequences.”

The couple eventually enlisted the help of Waterman’s Solicitors in Edinburgh to work on their case.

The solicitors have already gathered reports from independent surgeons and pathologists, and an independent CT scan report is due. When all these reports are in place the couple are hoping the evidence they produce will be strong enough to seek financial compensation without the extra cost of court action.

NHS Grampian medical director Roelf Dijkhuizen said the medical team would now seek a meeting with Mr Ball.

Dr Dijkhuizen said the decision to remove the whole lung had been taken by a team of radiologists, lung doctors, surgeons and pathologists which included some international experts. The team of six or seven people is brought together to protect the patient, he said, and they make a decision. In Mr Ball’s case “nobody thought it wasn’t cancer, it was a non-controversial decision. It’s almost as if we would do the same tomorrow and can’t give a 100 per cent guarantee it won’t happen again.”

However it is extremely rare, Dr Dijkhuizen said, and although one of the pathologists had read of such a thing in medical literature, there had never been a case in the Grampian area.

“It is most unfortunate and deeply regrettable, but it was not a blunder of an individual doctor or pathologist. All the indications were that he had cancer and we had to come to a decision.”

Dr Dijkhuizen admitted that the cells obtained in a bronchoscopy cannot give the 100 per cent certain diagnosis that a biopsy could yield, but a biopsy could only be done when the tumour was close to the outside of the lung. In this case it would have been too risky.

Mr Ball, it turned out, had a “massive infection” in the left lung which had caused “reactive tissue”, similar to scar tissue, throughout the lung. This was a very rare occurrence but changes in the cells looked exactly like a tumour and for this reason the whole lung was removed. Whether it was a tumour or not could only be determined after the operation when the lung was looked at under a microscope.

Dr Dijkhuizen said: “It was such an unfortunate coincidence. All the investigations pointed one way and cancer was not there.

“Everyone thought they were doing the right thing. It is intensely frustrating [for the medical team] and Mr Ball has to live with it. I don’t blame him for his reaction, I don’t think we’d explained everything to him enough and don’t think we’d communicated sufficiently with him. We are offering to meet him and it won’t put him off his legal case.

“He is pursuing a case for financial compensation and there’s nothing wrong with that, but his personal grief could be helped by a meeting. I’m sure we’d all feel better.

“If we haven’t done anything wrong there will be no legal case but it doesn’t take away that something happened.

“The team are all devastated and Mr Ball’s case has been the subject of endless discussion to prevent such a case in future, but very little has come out of it.

“It is a good team and our lung cancer survival figures are the best in Scotland. I’m so proud of that team and that makes it even worse.”

MSP Tavish Scott this week called for speedy “no blame” compensation for victims of NHS errors after taking up Mr Ball’s case.

Commenting on the legal battle Mr Ball now faces in order to win compensation from NHS Grampian, Mr Scott said: “I have been working with Mr Ball and his family to assist him in his case against NHS Grampian.

“What this case has made clear is that there is a need for a better way of handling NHS compensation cases when errors are made. NHS Grampian should not be using funding, needed to run the health service, to fight a legal battle against Mr Ball. And Mr Ball should not be forced to take legal action to get redress.

“There should instead be a speedy ‘no blame’ compensation scheme for the victims of mistakes by the health service. I shall certainly be taking this case to the health minister, asking her to recognise the serious flaws in the current position and urging her to introduce a fairer ‘no blame’ compensation scheme.”

• According to the Scottish Consumer Council NHS litigation payments in Scotland were under £10 million in 2007, compared to £40m in Wales and £500m in England. The consumer council said the statistics may show “greater barriers to obtaining compensation in Scotland than the rest of the world”.

• Mr Ball would like to point out that reports of him carrying out North Sea oil rig rescues and getting awards from bravery that appeared in the media this week are entirely without foundation.

• BBC Reporting Scotland said on Monday that Grampian health board had apologised. But as we went to press, Mr and Mrs Ball had still not heard from them.