Inquest into the Death of John HOUGHTON
Deceased
John HOUGHTON
Demographics
72y, male
Date of death
2014-07-11
Finding date
2017-03-31
Cause of death
Metastatic bladder cancer; likely mechanism pulmonary embolism from combined effect of cancer and hip surgery
AI-generated summary
A 72-year-old male underwent hip replacement despite undiagnosed metastatic bladder cancer. Following referral from his GP in May 2014 for an ultrasound showing bladder wall irregularities suspicious for cancer, urologist Dr S. did not consider cancer likely and arranged a flexible cystoscopy to exclude this diagnosis. However, no cystoscopy date was obtained before the hip replacement on 23 June 2014. The patient deteriorated post-operatively and was diagnosed with aggressive metastatic bladder cancer on 3 July 2014, dying 8 days later. Expert opinion differed on whether earlier diagnosis would have changed outcomes, but consensus held that cystoscopy should have been prioritised before elective surgery. System delays in obtaining diagnostic procedures in the public system contributed to this adverse outcome.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Specialties
Error types
Drugs involved
Clinical conditions
Contributing factors
- Failure to prioritise flexible cystoscopy before elective surgery despite suspicious ultrasound findings
- Delays in obtaining cystoscopy listing in public system
- Underestimation of cancer risk based on subtle ultrasound findings
- Prioritisation of hip replacement for pain relief over investigation of suspected malignancy
- Lack of informed consent regarding undiagnosed metastatic cancer at time of elective surgery
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