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

[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.

[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.

[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

[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.

[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.

[James31]

Sent signed for.

 

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

[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!

[James31]

Thanks for all the help. I pretty much have the full picture now, at least as much as I need to know for the purpose of my complaint.

 

I've written up the draft complaint for RCVS. It contains a number of serious issues (serial incompetence and neglect, defamation of another practice, manipulation of medical history, prescription of drugs without explanation or prior testing, improper record keeping, cover ups, etc).

 

Something interesting happened whilst putting it together also. There was such a vast array of info to go through, it wasn't so obvious before I put the doc together. It really appears as though our cat died due to toxicity caused by a drug prescribed 14 days prior to her death.

 

I have to tweak it here and there but I'm largely ready. The vet in question has not replied to my e-mail from last Thursday, so I e-mailed again last night to ask her to acknowledge it at least.

 

I only RCVS take it seriously.

[James31]

Solicitors letter arrived this morning, representing the vet!

 

They claim there has been no tampering with the medical notes, yadda yadda yadda.

[James31]

Indeed. There are 4 points in their letter, all of which I am about to p*ss all over in a reply.

 

See what they think about that.

[James31]

Only one reply, requesting information as I did previously. It is useful for my case.

 

My complaint is almost ready to submit.

[James31]

Hmmm, perhaps you are right. Maybe I should leave it. I keep thinking I need to get as much evidence as possible, but I guess that's the job of RCVS. I can't be sure.

[James31]

In terms of evidence, nothing concrete at the moment unfortunately. My wife sent personal e-mails to a friend an an aunty detailing the conversation the next day, and a couple of weeks later.

 

I have a receipt from the following day for a whole range of renal food and renal supplements (first order from that particular website). I am trying to find out from BT if I can obtain an incoming call log (they said no over the phone, so am writing to them).

 

The fact that CRF had been diagnosed is also contained within the notes of our old vet, but only having been passed on by us when we took the puss in for something unrelated, one weekend. I was hoping they might also have a faxed copy of the vets medical notes from that period, I am chasing this.

 

The missing data relates to a urine sample, the result of that sample and the call from the vet to us detailing the result (4 weeks to live). The sampe was performed on site, and was of a dip-test type so no records at a lab.

 

The last entry before the gap in the records says that a urine sample kit had been dispensed to us (she had to leave this in, it's on our invoice) and the following entry, 9 weeks later, records an incoming mail from my wife telling the vet how well the cat was doing. (Considering she was at that point, 5 weeks overdue for the reaper).

 

I spoke to the RCVS this morning who said that if there was a lack of evidence, they would need to form their own view as to whether or not the data was missing. They also said that whilst I couldn't insinst on obtaining call records from her telephone provider, what I *could* do was ask for the transcript of the phone call that apparently never took place, under the data protection act; which I think I might do.

 

With any luck, this dishonesty will be her undoing.

[James31]

Just remembered, I also ordered a headstone for our garden with our cats name on it. I have the receipt, it was ordered on the evening the vet called.

 

I had to re-order it this year, because it had the wrong year on it!

[James31]

Complaint bundle sent to RCVS with loads of supporting documentation, e-mail, witness statements, etc.

 

I never replied to the solicitors in the end. It was the right decision so thanks to all who suggested it.

 

Now for a wait...

Edited March 20, 2010 by James31

[James31]

...now signed for.

[James31]

Quickie update... Had a reply from RCVS a couple of weeks ago. Upon reading our complaint, they have indentified 4 possible conduct issues.

 

The vet in question has now been asked for a written response.

[James31]

Hightail, you are right. It ought to make them much more careful in future even if the complaint doesn't make it to the next stage (Prelimiary Commitee). Fingers crossed.

[James31]

I had a response from RCVS today. The case is due to be considered by the case examiners in 14 days.

 

They copied me in on the response from the Vet, who flatly denies ever having giving us the news that our cat had 4 to 8 weeks to live (based on a urine sample). Her response is just a long string of lies; and I have no reason to lie to you guys about this.

 

This is very upsetting news and leaves us in a situation where it's our word against theirs. Hopefully the fact that I had ordered a headstone for the garden at that time will prove that we'd had the news.

 

I'm not sure now whether to write back to RCVS, I have 14 days to comment.

 

James

[James31]

Sure, I had already sent them the order confirmation and design for the memorial, which I had ordered on the evening following the call last summer. I also ordered lots of renal food and suppliments (first time ever) on the same day, in an effort to save her despite the grave prognosis and timescale.

 

Perhaps I'll call them instead. Basically, I'd covered every possible fact and detail when I sent my bundle so to respond now would just be repeating the facts and pointing our her untruths. Putting my side against hers, it ought to be clear where the differences are.

 

Obviously, I haven't gone into major detail in these posts but any sane person could see (with all the evidence in front of them) that the vet is now lying through the skin of their teeth. I honestly wasn't expecting that, I thought they would either make up a decent story to cover themselves or come clean.

 

In fact, they did neither; just make out that the urine sample was good instead!

[James31]

Hightail, I did include details in my original complaint, they would have seen that.

 

Aside from "justice" if that's the right word, we genuinely wouldn't wish her level of expertise and care upon others with whom she deals with. In fact those two reasons are 50/50 for going ahead with this, for me personally.

 

I can't believe she has lied to RCVS though in her response on so many counts. Surely would have been better for her to come clean.

 

I wrote a letter to RCVS to remark on a few points from the vets response (where such comments were not a repeat of what I'd already cited) and posted it to them on Monday.