9^th June 2013 [blog No. 27]

Hello again, it’s me, Peggy

I’ve just found this when reviewing my case files, it’s a letter dated 18^th May 2000 from Mr E Drake (Investigations Manager) at the Health Service Ombudsman’s Office and the letter had a report enclosed which reported on the Bassetlaw Hospital 1991 x-rays and x-ray reports of my left and Right knees allegedly by their In-House Medical Expert, albeit it does not carry the so-called expert’s signature.

I say allegedly because if an expert in anything wrote the report (apart from an expert comedian) I will eat my hat. But there again, if it was actually written by the Health Service Ombudsman’s In-House Medical Expert, it would account for the Health Service Ombudsman failing to act professionally in his/her duties. See copy letter and Report copied below.

Comments by the Health Service Ombudsman's In-house Professional Medical Adviser in relation to Mrs M A Barnes' complaint about x-rays taken in 1991

X-rays of limbs can always provide problems because they are paired and because of the transparent nature of x-rays, it is possible to put them onto a viewing box the wrong way round.

An x-ray report forms part of a patient's clinical record and contains the opinion of the doctor who wrote the report. This report may or may not be accurate and may or may not have been carefully delivered to a secretary/typist who may or may not have made a secretarial error.

All the x-rays in the trust have been examined by the consultant radiologist and clinical director,

Dr Howard, and I think that the Trust claim that they have now sorted out that the x-ray file is

acceptable. Further the Trust has agreed to add Mrs Barnes' additional note to the report of her

1991 x-ray.

Mr Zaroti, who saw Mrs Barnes on 15/11/1996 after a fall seems to have raised a large number

of questions in the Barnes' mind when he mentioned "foreign body in knee" - because he

showed them a shadow on the x-ray in 1996 and it was also present on the 1991 x-rays. When

told that Mr Dandy had operated in 1989, Zaroti commented that he must have missed it. This

was his opinion on that day but he could not substantiate this because he did not have any pre

1989 x-rays.

The missing fourth x-ray: It is usual to take a picture from the front to the back and then a side

view of each limb. The front to back ones are called (AP or antro-posterior) and both knees are

usually put onto one film. Sideways or lateral views are performed on each knee separately. It is

not possible to do one x-ray from the side because the two set of bones would overlay each other.

It sounds to me as if there was some technical problem because Mrs Barnes was recalled for a

second lateral x-ray. This could have been because of a technical problem and at some later date

such a film might have been destroyed. This would be normal practice.

At every stage in treatment, orthopaedic surgeons request separate new x-rays. They rarely refer

to the reports by radiologists and even if there was an inaccurate report in the notes, it is unlikely

that this would influence a patients care.

I have looked at the one x-ray on file and the loose body certainly looks well outside the joint

cavity and it is probably that it is in the soft tissues. It is possible to gain an impression that there

might be something in the tibia (the large bone of the lower leg) but it does not show up as metal

in the way that metal normally is revealed on an x-ray.

In conclusion, I would like to re-emphasise that a report is the opinion of a doctor. It may be flawed and inaccurate but it is not usual or appropriate to go back and alter a report.

NB: The above document does not carry the signature of the author.

You can see by referring to my 4^th Blog (on 17/1/2013) that I had complained to the Information Commissioner (Mr Iain Bourne Health Sector) alleging that the Bassetlaw Hospital X-ray Report for the 19/08/1991 x-rays taken of both my knees had been altered. I did this because the Report for the Right knee did not mention the absence of the Patella and the Report for the Left knee x-rays reported on one or more loose fragments, and of course it was a piece of bone (a bony lesion) that was eventually removed from my Right knee by Mr Bickerstaff at the Thornbury Hospital on 22 November 2002.

See file copy of my letter of response to Mr Drake dated 29^th May 2000 copied below.

When Mr Bourne referred the case to Mr Drake at the Health Service Ombudsman’s Office he did say that if only from the semantics of the reports he believed Mrs Barnes has a case.

This true story continues …….

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