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Coroner advises change after MRI scan confusion

Chris Hudson
7/11/2007

MACCLESFIELD Hospital told a man he would have to wait three weeks for an MRI scan then performed the same service privately for £700 and waived the fee after results confirmed there was a serious problem, an inquest heard.

And confusion over three requests from a GP to the hospital for a scan has led to a coroner advising changes be made over lines of communication.

Long-serving retained fireman, Kevin Nolan, 64, of Barnfield Road, Bollington, also had to wait six-and-a-half hours for his scan report to reach Hope Hospital – where he was to be operated on – because of a mix up sending them by taxi, a coroner was told.

And the day after the grandad-of-three’s funeral – which filled St Gregory’s Church in Bollington – an MRI scan appointment slip was sent to his family home.

Deputy Coroner for Cheshire, Dr Janet Napier, called for changes in the system of communication between GPs and Macclesfield Hospital consultants as she recorded a narrative verdict at Macclesfield Town Hall.

She said Mr Nolan’s death was due to complications of anti-coagulation therapy following heart surgery and possibly associated with minor trauma to the blood vessels in the brain.

She said: “It is very tragic that he should be lost and I need to make a comment. It seems sad to me that the GP couldn’t get through her wishes for an MRI scan.”

She asked for it to be relayed  that if a doctor is concerned for a patient they should ring the hospital personally.

Speaking after the inquest Kevin’s best man, George Abbott, 64, said: “I miss him every day – everybody does – he was the most honest person I have ever known.”

In a statement read out by her son, Barbara, 66, Kevin’s wife of 40 years, said that he had heart surgery in October 2005, was in rehabilitation and was taken to Macclesfield A&E on September 22, 2006, after suffering headaches and neck pain but an X-ray proved inconclusive.

She said his doctor sent an urgent fax on September 27 and followed it up the next day with another, after getting no response, and then called the hospital when his headaches continued.

The mum-of-three said she was told by a receptionist that it would be three weeks for an MRI scan.

She said: “I asked her ‘How do we know what’s going on in his head?’ She replied that I was desperate and I said my husband is fading away before my very eyes. She said to go private and it would be £700.

“Afterwards a man who I assumed to be in charge said Kevin had a considerable bleed in his brain about the size of his hand and there would be no charge for the scan.”

Kevin’s son, Mark Nolan, of Cedarway, Bollington, told the inquest that the MRI scan was carried out at 11am and at 4.30pm the ward sister was given a message to send his notes by taxi to Hope Hospital.

Kevin was transferred to Hope Hospital and died after two  brain operations on October 15.

Representing Macclesfield Hospital Dr Michael Crotch-Harvey, a consultant radiologist for 11 years at Macclesfield, said the hospital waived the fee because he “imagined they felt sympathy towards the family” and they “would have known the difficulty of getting the scan”.

He said: “It is as much a frustration for us as for the family concerned. Unfortunately it is symptomatic of the NHS and the resources we have.”

Neuropathologist Dr Du Plessis gave the cause of death as a stroke due to an acute brain haemorrhage.


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Most recent 1 of 1 user comments

   As a Consultant Radiologist myself there are a number of things which stike me as strange in this story. Firstly the examination of choice here would have been CT scan which is much more readily available throughout the UK and would have shown the problem in minutes. I can't speak for your local hospital but GPs usually have access to urgent CT but not urgent MRI. It is easy in retrospect to see that more urgent action should have been taken but when there is such concern about a patient the GP usually discusses the need for urgent scan with the Radiologist or, failing this, arranges for the patient to be reviewed by a hospital specialist. If, after consideration, we think a scan is not justified we do offer the patient a choice of having it done privately but we only charge £200 for a private CT or MRI. The suggestion here was that the family was being asked to finance a clinically justified urgent scan to the tune of £700 and this would indeed be of concern. The refunding of the fee was correct in this circumstance but would be an interesting business plan for a private scanning company. Only charge if normal! Xavier
dr xavier ray, Hereford
12/11/2007 at 10:11
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