No treatment plan for the bullae
13. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that something has gone wrong.
14. Mr O told us he felt his treatment had been ‘very poor’. He said the bullae on his lungs ‘should have been followed up by someone’ and it was ‘wishful thinking on his behalf’. He said there was a ‘reference on Hull hospital’s website’ that ‘lung nodules’ need to be followed up. He says he is now in a position where he feels ‘reluctant to get treatment’ if his condition becomes more serious.
15. We are very sorry to hear Mr O has lost faith in the Trust’s service. We recognise he felt frustrated and anxious when it did not agree to remove the bullae on his lungs. We do not underestimate how stressful and worrying this must has been for him.
16. To fully and carefully consider Mr O’s comments we first looked at the Trust’s website. It has a patient information leaflet about lung nodules. The leaflet explains what a lung nodule is and what tests are used to identify nodules on the lung. The Trust explain after the initial diagnosis ‘if a repeat CT is required, it will be arranged as per nationally agreed guidelines’.
17. This leaflet suggests the Trust considers each patient’s care and future treatment plan based on the findings of the initial CT scan. It does not say every patient should need follow up treatment. That said, we next looked at Mr O’s specific care to see if his treatment was appropriate.
18. The 2010 medical paper for ‘Thoracoscopic surgery in the treatment of patients with bullous emphysema’ explains what should happen when a patient is diagnosed with bullae on the lung.
19. It says when patients have small bullae on the lung, it is not recommended to carry out further surgical treatment. This is because, the resection (removal) of small bullae ‘generally has little effect on lung function’. It continues to explain further treatment and surgery is only considered when the bullae increase in size, compress ‘good lung tissue’ or create complications such as ‘bullous diseases’ or a ‘pneumothorax’ (collapsed lung).
20. We asked our adviser to review and comment on Mr O’s CT scan of July 2022. They confirmed the CT scan findings show he did not have large bullae on the lung. Further, there was no evidence of lung complications or a pneumothorax on the CT scan. Finally, Mr O’s records did not show he had emphysema (a lung condition which causes breathing difficulty) which had become worse
21. That said, in line with the above guidance, it appears the Trust made an appropriate decision not to plan any further surgery to remove the bullae. Mr O did not have large bullae or lung complications which required further surgical treatment. We would also like to reassure him our adviser confirmed Trust staff correctly referred him to a cardiologist to start him on neuropathic pain medication following the findings of the CT scan.
22. In summary, we have seen no indications something went wrong with Mr O’s treatment. We hope we have clearly explained the reasons for our decision to give Mr O closure for his complaint.