CONCERNS have been raised after NHS doctors failed to inform an elderly patient that removing a cancerous lump would leave him with “extensive facial disfigurement”.
James Whitecross, 76, was referred to the ear, nose and throat clinic at Forth Valley Hospital in January 2014 after discovering a small swelling behind his left ear.
Doctors discovered it was cancerous and told Whitecross he would need surgery at the Southern General Hospital in Glasgow as most of the specialists were based there.
His daughter Lorna Tannock said the family were told it would be a minor procedure, but the result was a “mutilating surgery” which left her father unable to walk, eat properly or see in the initial weeks.
Tannock, 40, said: “It looked like half of his face had been removed. I thought I was going to faint.”
The retired farmer had lost most of his left ear, and a 20cm flap of his cheek and neck had been completely cut away after the operation in March last year. He also had stitches in one eye and across his lips and a 38cm scar on his leg where a skin graft had been taken for his cheek.
Tannock said: “A week later I had to tell my dad the news as he didn’t understand. He kept saying, ‘It’s going to be okay when they take this bandage off my face’, and I had to say, ‘Dad, it’s not a bandage’. It was mutilating surgery. We had no concept of any of this. We thought it would be a small lump removed and a small skin graft from his forearm.
“I am very grateful to the NHS that I still have my dad here with me but there have been times since when my dad has said he might not have had the surgery if he had known what would happen.”
Since his surgery, Whitecross, of Alloa, Clackmannanshire, has had to undergo radiotherapy alongside struggles with his balance, walking and eating solid food, as half of his jaw was removed during the procedure.
His wife Christina, 71, who has recently overcome breast cancer, has been a full-time carer for him since the operation.
Tannock, of Menstrie, Clackmannanshire, said there were significant problems with organising referrals for physiotherapy and a dietician.
She added: “I complained but it seemed like each NHS board was pointing the finger at another. I think it’s a systemic problem.”
Ombudsman Jim Martin said there needed to be “clearer lines of responsibility” when patients were transferred between NHS boards and urged all of the Scots health boards to learn from the case.
He said: “It is crucial that patients are given enough information about planned procedures to allow them to make an informed decision. They should also be given enough time to make a decision.”
Lessons must be learned from this “deeply traumatic” case, said Jean Turner, patron of the Scotland Patients Association. She said: “It is shocking that someone should think they were going in for a minor procedure in this kind of case. The psychological trauma this patient suffered must have been huge, if he thought he was going in for a minor procedure and he woke up missing an ear and with facial disfigurement.
“It is a very scary thing to have a cancer diagnosis anyway but to not fully understand is worse. It would be deeply traumatic.”
NHS Greater Glasgow and Clyde has apologised and pledged to fully implement the recommendations. A spokesman said: “We absolutely accept that the communication with this patient fell short of the standards that we expect and we will be writing to him to offer a full apology.”
NHS Forth Valley spokesman said it was a “very difficult and distressing” experience for the family. He said: “Actions from the meeting with the family are in place and we have been working with colleagues in the other health board to make improvements to the pathway.
“The Ombudsman has recognised that NHS Forth Valley has already implemented an appropriate action plan which will be further developed to take into account the findings of their investigation.”