Vet misdiagnosis

[James31]

Hi,

 

We've been using a vet for the past year that works exclusively on a home visit basis, because our cat always got quite stressed by the trip to the vets.

 

Now, this vet works 9 to 5, Mon to Fri and will only come out outside of those hours for euthansia or the prospect of it.

 

We initially called her out because our cat handn't eaten for a couple of days. She took a urine sample and told us that her kidneys had failed, there was nothing that could be done. Prognosis was up to 4 weeks, 8 at a push. Euthanasia was offered, just a phone call away.

 

8 months later, she was still going strong. We assumed she was a real fighter! A couple of weeks ago, she had a slight cough so we called out the vet again, who diagnosed a heart murmor and prescribed Fortekor.

 

During the first week of taking Fortekor, she became very quiet and lethargic. We decided to stop giving it to her.

 

On Thursday she wasn't eating and seemed quite unresponsive and not herself at all. The vet came out again on Friday and diagnosed constipation.

 

On Saturday morning, we noticed she had developed jaundice. Once again, the vet came out, took a blood sample this time and then called back to tell us that her liver had failed. There was no hope, not to take her to another vet - there was no point.

 

I wasn't ready to accept this so I took her back to old vet, where they re-performed a blood test and told me that whilst her liver is not functioning correctly, her kidneys are absolutely fine. She did not have kidney failure. He said you can not diagnose kidney failure (CRF) from a urine sample, especially not from a paper dip test sample.

 

This has made me extremely angry. For the past year, we have been basing our care and treatment around the fact that we had a cat in CRF. Now I discover it was her liver all along (similar symptoms, different treatment!). Effectively the home vet had guessed a diagnosis without having the proper information in front of her; i.e., a proper blood test.

 

Our beloved cat is currently on a drip for the weekend. The prognosis is very poor.

 

I post this in the hope that people will read it, and understand the importance of regular, full blood works in elderly cats and the value of second opinions.

 

James

[hightail]

Read Elsa's post at the top of this section giving information on how to make a complaint to the RCVS and then do it. If nobody complains then nothing will be done and others will continue to suffer. You must flag this up.

 

I've known a wonderful farm vet who would do home visits for vaccinations etc. because he wanted to keep his hand in with small animals but he knew his limitations. There is no way nowadays a lone vet could possibly run a full service without a base surgery. Does she have a mobile x-ray machine with her? Can she run the simplest blood panel - normally done in any surgery giving results in minutes. I'm not surprised her reaction to a sick animal is euthanasia, she doesn't have any way of finding out what the problem is. There's nothing wrong with home visits. I sometimes pay my vet to do just that but without the backup facilities it would be pointless.

[James31]

Thanks. I have e-mailed RCVS for advice, but their website states that they don't usually get involved for cases regarding neglegence, which I believe this is.

 

The mobile vet involved has (recently) attained some relationship with a local surgery for which she can refer animals to. They also can do blood tests for her. That's who did the blood test yesterday.

 

A couple more odd things though. Yesterday, she claimed to have a working relationship not just with that surgery, but the old one we used to use prior to using her. Last night, they told me that no such relationship exists and that they deliberately do not work with her. They have their reasons, but wouldn't say any more.

 

Whilst with us yesterday, taking the blood test, she incinuated that our old vet's facilities were antiquated and that if we so felt the desire to take our cat to a surgery, we should use the one she is using.

 

Last night, at our old vets, they had the blood test from earlier that day faxed over to them, and it wasn't a full bio chem test, so they ran their own which took 15 minutes. She had told us that we would be waiting "ages" (days) if we had gone there. I hope this makes sense... I'm not writing the best at the moment!

 

Personally, I feel that her practically guessing that our cat had CRF based on a dodgy urine sample is a serious offence. I'm just not sure if anyone else would see it that way, so asked the RCVS for advice.

 

This woman boasts of having made 5,000 home vists in the past 5 years. Her website is littered with her great euthansia service, and every advert or mention of her company is always full of euthansia crap. If we had listened to her 8 months ago, our cat would already be dead.

[hightail]

I read your first post and deliberately made allowances for you being a touch upset at present but even allowing for that there were alarm bells ringing aplenty. If she is a vet running a practice (mobile or otherwise) then there are various things she must do under RCVS. One of these is to provide out of hours emergency cover - for necessary treatment not just euthanasia. She doesn't have to do this herself but she must have a proper arrangement in place.

 

Something is VERY wrong here. Have you contacted the surgery she claims to have an arrangement with? It may not be a formal arrangement at all in which case she is breaking RCVS rules. From what you've said so far I'd wonder if she is even a vet. If you are prepared do follow this up you could be saving others from the misery she caused you.

[hightail]

I have e-mailed RCVS for advice, but their website states that they don't usually get involved for cases regarding neglegence, which I believe this is

You aren't claiming negligence, you are making a complaint about professional misconduct. Edited February 14, 2010 by hightail
typo

[James31]

She is registered with RCVS, qualified in Denmark in 1999 according to her site.

 

Despite all of the other misgivings and concerns I have about this woman, my primary and main concern is the fact that she has diagnosed a serious, terminal illness based on a basic urine sample. Everything else is just noise I suspect, but there's plenty of it.

[hightail]

For all you know there may be other complaints. This is a real problem when emotions are involved as they are with animals. If you had such a poor level of service with a 'thing' you'd be shouting loud. If you can bring yourself to write to the RCVS it will at least go on file. We have to put our trust in professionals like vets and we are entitled to a level of professionalism and expert judgement. In your case the level has fallen badly short and needs to be questioned - or at least recorded.

 

You could do a subject access request. You are the client and for a maximum of £10 she would have to give you a complete copy of any records she holds on animals you have registered with her.

[James31]

I'm afraid our little moggy didn't make it last night. We went to visit her at the vets and she was in an awful state, we had to put her to sleep.

 

I had a reply from RCVS today who basically said the don't want to know.

 

Going to take a few days out.

 

Lady r.i.p.

1992 - 2010

[ncf355]

James,

 

from my PM's you'll know I've been there recently

 

My utmost sympathy to you and your partner on the loss of your puss cat, I know how wrenching it can be

 

[mazbck]

James, Im really sorry about all your problems you have had with your vet, and my hearfelt sympathies go out to you just now after losing you moggie. xxxxx

 

Once you have had a few days to yourself, have a look at the code of conduct for the RCVS, I currently have a complaint in as well about a vet, with the complete backup from his employer. A very bad case of negligence with our dog, which is currently being investigated by them

 

RCVS Online / Find a Vet / Unhappy with your vet?

[James31]

I'd really like to get RCVS to take my complaint seriously but I'd like some outside opinions from you guys about whether or not I can convince them that this is a misconduct case rather than negligence. They do state that multiple occasions of negligence can be investigated but the wording is pretty loose.

 

The fact that she did not perform the correct test (simple urine dip test vs full blood) and thereafter diagnosing CRF when in fact her kidneys were fine started a chain of events that would otherwise have not happened.

 

First, our cat was prescribed three rounds of anabolic steroids on the basis of her having CRF. These are known to put stress on the liver. During her taking these steriod injections, she became stressed and ran around the house, howling for weeks on end. When the third round of steroids wore off, she returned to her usual self, but by this point she was drinking water whereas previously she rarely touched her water bowl.

 

Her life expectancy at following the urine test was said to be 4 weeks. This put enormous stress on my wife and she has spent 8 months waiting for our cats kidneys to fail.

 

There was no follow up test of either urine nor blood offered to us, even though the cat had clearly surpassed the original 4 week prognosis, in fact she lived for another 8 months.

 

We had put our cat on a CRF diet and given suppliments for the same. CRF is not treatable, but liver failure can be treated effectively depending on the cause.

 

Every time the vet came around, she didn't take the cats temperature, never explained her thoughts or actions sufficiently, seemed wooly in her remarks. This is in stark contrast to our old vet who I saw last week, who reminded just how things should be; fuller explanations, possibilities, probable causes, options, etc. We were even shown the results of the blood tests that night along with facts and figures. I had no idea blood tests gave so much information.

 

We feel that our cat, had we had the correct diagnosis, had another good few years in her. We'd have put poured our efforts into liver treatments instead of kidneys.

 

My wife even lost a baby last year, at a time where she was already stressed out waiting for the cats kidneys to fail, crying almost every day, thinking every day could be the last.

 

In short, this vet should not be practising. If you compare her level of competence and understanding to every other vet we've seen at the old clinic, it becomes very obvious that she is a bit of a lemon.

 

I don't want to sue or have financial gain from this, I simply want everyone around this local area that we live to know that she is not very good and not to be trusted. How many other animals are there needlessly being put to sleep by her and not being cared for correctly? She had offered euthansia to us about 4 times.

 

Following the urine test she did last June/July, it wasn't even the case that she said our cat had CRF and that there were options. No options or treatment were explained. Instead, she said the kidneys had *totally* failed and were not working whatsoever, there was no hope, she should be euthanised soon because she only had 4 weeks left. Even though she told us this we tried things oursleves anyway.

 

The truth was that her kidneys were fine. How wrong can you get it?

 

Even in the final days, she diagnosed constipation, not noticing that she had jaundice (we did a few hours later).

 

Please be honest and tell me if we are the ones in the wrong here and that this is just life, etc.

[hightail]

James she was a very old cat and had to die of something at some time. This doesn't mean the vet was good enough, far from it and you know I'm appalled at what you've been through. I do think you should follow this up if you feel strong enough.

 

I mentioned a Subject Access Request in an earlier post. If you make such a request the vet MUST give you copies of all records held on your cat. According to the RCVS she is required to keep proper records so I think this should be your first step. You will then have the documentary evidence of her diagnoses and treatment. Either the notes are accurate and will show her misdiagnosis through lack of proper investigation or there will be bits missing. Whichever, you will have some real evidence to back your complaint.

[James31]

I certainly am strong enough. I do understand that she was old and couldn't live forever. What I'm annoyed about is that we have spent all this time focussing on her kidneys, instead of her liver which could have been for more manageable and given her not just a longer life, but a more comfortable one.

 

Your advice is actually exactly what I am doing. I am about to send a letter and £10.

[hightail]

Send it 'signed for' at the very least. I don't have too much faith in her eagerness to comply. I didn't mean to sound harsh about your cat's age but this is what her answer would be which is why you need this evidence to make a complaint. Even if you can only flag up a lack of proper record keeping it would be something properly noted against her.

[James31]

Sent signed for.

 

She has to comply under section 2A(7) of RCVS Guidelines for Conduct, and the DPA.

[Undercover-Elsa]

Hi James31,

What a horrendous story. I agree with all above and feel this person sounds highly incompetent, if not downright dodgy.

Apart from her website, have you checked on the RCVS site that she's actually registered to practice? RCVS Online / Veterinary Surgeons / Check the RCVS Register

 

Her attempts to divert you from obtaining a second opinion are questionable, as is her constant pushing of euthanasia. Burying the evidence?

The first step is a formal written complaint to her, detailing your concerns, then depending what she says in response escalate it further with a formal complaint to the RCVS.

Concentrate on misdiagnosis and providing inappropriate and potentially life threatening treatment on the basis of grossly inadequate diagnostic tests. In prescribing such treatment for a condition your cat was not suffering from, without medical justification, she not only neglected to provide the correct treatment the cat should have been having, but induced further serious illness in response to the treatment, which directly led to the deterioration and ultimately death of your cat.

 

Complaint form: http://www.rcvs.org.uk/Shared_ASP_Files/UploadedFiles/rcvs/10FD904C-DDBD-4FED-9F38-478DCA78FC1C_Complaintform.pdf

Guidelines on negligence: http://www.rcvs.org.uk/Shared_ASP_Files/UploadedFiles/4FDDCC8C-7954-4882-BC40-289667B4E3FA_AN02_Negligence.pdf

Would your other vet back you up on this? If not you may need to Subject Access Request him too.

 

Finally, if it's the only way to protect other animals, some No Win No Fee solicitors take on veterinary negligence...Google is your friend here but watch the small print and make sure you're completely covered for costs..

 

Let us know how you get on

 

So sorry for your loss,

Elsa x

Edited February 17, 2010 by Undercover-Elsa

[Justice For Ted]

Hi Everyone,

 

I lost my Great Dane Ted earlier this year due to what I believe was veterinary negligence. I echo all of the frustrations cited above.

 

I was so incensed by the inability of the RCVS to police veterinary negligence that I started a campaign Justice For Ted Justice For Ted - Justice For Ted, soon to be called Rights 4 Pets @ Vets as soon as our new website is ready.

 

We are campaigning to change the current outdated veterinary complaints procedure, which despite the Royal College of Veterinary Surgeons and DEFRA having been in discussions since 2003, remains unchanged since 1966.

 

We want to state emphatically that this is NOT a campaign against the veterinary profession. We recognise that the overwhelming majority of vets do an excellent job but on the rare occasions that things do go wrong, owners must be afforded a transparent and robust complaints process.

It is not until something goes wrong that you realise just what a difficult and tortuous process it is to make a complaint. Sadly it was the tragic and unnecessary loss of my own beautiful Great Dane that has brought this to light for me and you can read my online diary at Justice For Ted and about others who have faced the same hurdles.

 

It is time to lobby support and campaign DEFRA to allocate funding for change to this outdated law and allow pet owners the opportunity to make their complaints heard and acted upon.

 

Please take the time to look at our website Justice For Ted - Justice For Ted and sign our petition at Petition to: Make Veterinary Surgeons more accountable for their actions. | Number10.gov.uk

 

My local MP is fully behind the campaign as is TV's Peter Purves and outspoken veterinarian Matthew Watkinson. We have been featured in recent articles in Our Dogs, K9 Magazine and we will also be the subject of features in Your Dogs and The Veterinary Times and Veterinary Journal.

 

Please get involved with us! We will be starting on a fundraising exercise soon. Owners and pets deserve a voice!

 

Regards

 

Sarah Deadman

Justice For Ted

[The Chez]

This really is disgusting. Cats can be VERY deceptive in how they communicate illness. When I was a child we had a cat & she lived for about 14 years. As she entered her golden years, she had a few illnesses, but our vet, who was useless with people but AMAZING with animals, kept pushing her on, wherever he saw life, he made her live. He seemed to know she wasn't in enough pain to be put down, so he always treated her with the most precise, perfect care. She lived to a ripe old age & eventualy passed away at home with her family on her favorite chair, rather than in a steal cage at the surgery surrounded by barking dogs & strange faces.

 

I think this is more a misconduct case, because rather than actualy put your cat down, she suggested via a misdiagnoses, that this should happen, on more than one occasion.

 

Neglegence as far as I know applies when physical harm has happened, I spose by misdiagnosing your cat, further harm could have happened. It is a hard one, nobody seems to regulate vets in the way they should be regulated.

[Trojan Horse]

Dear James

 

I am a practising vet

 

I do not understand how a veterinary surgeon can offer a professional service based on home visits without her own surgery base.

 

You have the right to lodge a formal complaint to the RCVS and they are duty bound to follow it up by writing to the vet for an explanation.

 

If you write to them about the events surrounding the misdiagnosis of your cat's illness they will direct you to make a claim against the vet for negligence.

 

What you need to do is to make a complaint about the way you believe she is practising, illustrating this with evidence from your own experience. Make it clear that you are not seeking compensation but drawing their attention to the fact that a member of the profession may be operating outside the RCVS Guide to Professional Conduct, in such a manner that she is jeopardising the health of her patients.

 

For all you know she may be carrying medication with her that is not being kept in a correct manner. She may be leaving medication with her clients without correct labelling. All of these misdemeanours will add up to a disciplinary reprimand and a call to get her act in order. If she is sufficiently off track she may have to give up practising in this way - and you will have achieved the goal.

 

Most vets who work like this do so because they are happy if they are earning a living to get them by, but can't really afford the outlay of a surgery with inherent overheads.

 

By stirring up a hornets nest you may achieve more than you think.

 

With best wishes

[James31]

TrojanHorse, many thanks for your reply. I agree with all that you have said and was thinking along similar lines. I wouldn't mind PM'ing you about something in the future if you don't mind.

 

Update: Today I received the information I had asked for. Invoices, some test results and a client record.

 

Shockingly, there is a large (9 week) period missing from the client record. This is the period in which the vet performed the urine sample and told us that our cat's kidneys had failed, giving her 4 to 8 week max prognosis. There's no mention of it.

 

The entry before the gap says: "Disp katkor x 1, katkor Urine sample kit for SG". The next entry, 9 weeks later says "Email from Mrs X saying cat is doing amazingly well..."

 

I need to sit with my wife to check all of the remainder of the notes (8 pages worth) and have held them back from her so that she is recalling only her own memories and nothing from this document. I have read it, and there are several instances that would appear to have been edited to in the vets favour - they do not ring true.

 

I have just e-mailed the vet to ask, in the first instance, for the missing portion, but not outlined what I expect that portion to contain in any detail whatsoever. The gap is very inconsistent with the remainder of the document and very obvious. It occurs to me that if they maintain backups, the true data would be within them. Not sure of possible avenues there.

 

Although I have an awful lot to go on besides this, although this is the most important part of our case.

 

 

James

Edited March 11, 2010 by James31

[James31]

Hmmm. Having had a better look at the printed client record, I think the vet has also "doctered" some important parts. I'm a software engineer by trade. I won't write my reasoning here just at the mo but there is a fairly strong sign of the vet having edited the original data, looking at that report. It only occurs on the pertinent points, not on any innocent/unrelated entries.

 

I think the best thing to do at this stage would be to speak to somebody at the RCVS and tell them that I am trying to gather information to support a forthcoming complaint, and tell them my concerns regarding the data, especially with the most important part of the whole doc just completely missing/removed as I mentioned in my previous post at the bottom of page 1.

Edited March 11, 2010 by James31

[James31]

I've e-mailed the vet to ask for a true copy of the client record and cited my reasons why, on advice of RCVS.

Edited March 11, 2010 by James31

[James31]

No reply from the vet. Chased.

 

Started on putting the complaint for RCVS together. I wish I could understand the test results and medications a little better! It's times like this I wish I had a vet as a friend!

[hightail]

Trojan Horse posted earlier in this thread and may help if you send them a pm. If that isn't an option I am happy to have a look at any results for you. I'm no vet but I'm not too bad at reading lab results for cats and can always call on breeder friends with even more experience.

 

For the medications side Google 'Noah Compendium'. This will give you much of the information you need on any drugs your cat was prescribed.

[Undercover-Elsa]

I'm happy to have a look too James, for what it's worth (retired SRN)

Several heads better than one, I'm sure we'll figure it between us

Elsa x