large volume aspiration following right hemicolectomy for adenocarcinoma of the colon
AI-generated summary
A 75-year-old woman with a 20-month history of iron deficiency anaemia was not investigated for its cause by her general practitioner despite clear clinical signs of deterioration. The coroner found this fell 'grossly short' of the standard of care expected. When eventually diagnosed with colonic cancer at the hepatic flexure, she underwent right hemicolectomy but died from aspiration two days post-operatively. Medical adviser Dr Bell opined that prompt investigation of iron deficiency anaemia would have enabled earlier cancer diagnosis when the patient was in better health, potentially offering 50% five-year survival compared to her actual outcome. The case highlights the critical importance of investigating the cause of iron deficiency anaemia, particularly in older patients with systemic symptoms, rather than simply treating the anaemia itself.
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Specialties
general practicegeneral surgeryhaematologygastroenterologyemergency medicine
Error types
diagnosticcommunicationdelay
Clinical conditions
iron deficiency anaemiacolonic adenocarcinomamalabsorptionshort bowel syndromeretroperitoneal fibrosis
Procedures
right hemicolectomycolonoscopygastroscopy
Contributing factors
failure to investigate iron deficiency anaemia for 20 months in primary care
failure to pursue referral to hospital for investigation of iron deficiency
erroneous assumption that anaemia was due to malabsorption at hospital
substandard medical care at hospital during medical ward admission
late diagnosis of colonic cancer resulting in deteriorated patient condition before surgery
patient's significantly declined functional status at time of surgery
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