M v Colchester Hospital University NHS Foundation Trust

Abstract

In 1984, M was diagnosed with a large sub-frontal meningioma and underwent removal of the tumour which, macroscopically, was complete. Immediately after the operation, her vision recovered save for a slight visual field defect in the left eye. In 1988, having moved to Essex, she underwent a CT scan at the Defendant hospital which showed no evidence of recurrence, and she was discharged from the neurosurgical clinic. In 1993, M was referred to the ophthalmic clinic as her optician was concerned about deterioration of vision in her left eye. Her visual acuity was measured at 6/5 in the right and 6/12 in the left. It was noted M was anxious about a recurrence, but she was reassured and sent for a CT scan. The hospital was to monitor her visual fields every two months to see if there is any serial change. The CT was reported in July 1993, and there was said to be no evidence of significant mass effect nor of abnormal contrast enhancement, with a normal ventricular system. The low-density changes in both frontal fields were presumed to be due to previous surgery. The scan had been lost or destroyed by the time of the claim and so could not be reviewed. M was reviewed by the Ophthalmic Consultant in September 1993. Visual acuity in the right eye was noted to be 6/5 and in the left 6/9, a slightly pale left disc and field defects in the left eye ‘of long-standing’. The Consultant advised her GP to ‘keep herself assessed about once a year and if there is any change on the situation we shall be happy to see her again’. He discharged M from clinic. Notwithstanding their own management plan, M was not kept under review by the clinic. In August 2000, M’s optician advised her GP that M had visual acuity of 6/9 in the right eye and less than 6/60 in the left with a widespread area of decreased sensitivity in the right and that, in view of her history, this should be investigated further. The GP duly referred M back to the hospital where she was seen in October 2000. On examination, her visual acuity was 6/5 in the right eye and 6/60 in the left eye. She was to be reviewed in nine months’ time. M received no appointment. By 2003, M was noticing deterioration in her functional vision. She required help at work and at home with reading and had given up night-driving. In January 2004, her optician recorded acuity in each eye as 6/12.M attended the hospital inMarch 2004 to review if she could continue driving and was recorded to have visual acuity in the right eye of 6/36 unaided, 6/36þ 1 with glasses, and in the left eye 6/18 unaided, 6/12-1 with glasses. There is no evidence that she saw a doctor in the clinic, or any note of a management plan or review. Her driving licence was revoked in April 2004.