• Sweden edition
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Man dies after twenty doctors ‘miss’ his cancer

Published: 23 Mar 12 08:00 CET | Print version
Online: http://www.thelocal.se/39838/20120323/

Some twenty physicians in northwestern Sweden failed for months to realize that a patient was suffering from cancer of the larynx for months until a few weeks before he died.

The man sought medical advice at his local health clinic, suffering from abdominal pain, loss of appetite and coughing blood, according to local paper Värmlands Folkblad (VF).

He was referred to the nearby hospital in Arvika, where he underwent an ultra sound scan and a lung x-ray, and the results caused the doctors to believe he was suffering from a broken rib.

However, no better, the man returned to the clinic in June, new examinations were carried out at the hospital and later at another hospital in the area. This time the patient was prescribed laxatives and painkillers.

According to VF, there was a suspicion of lymphoma, but a referral to have a scan, which was written in June, wasn’t carried out until October.

At the beginning of November, the suffering man underwent a gastroscopy, which detected cancer of the larynx. He died a few weeks after getting his diagnosis.

The incident has been reported twice to the National Board of Health and Welfare (Socialstyrelsen) according to Lex Maria, the informal name for regulations governing the reporting of injuries or incidents in the Swedish health care system.

One of the reports comes form the county council (Landstinget), and the other from an individual.

According to VF, the latter states that the patient had been forced to see at least 31 different doctors and that that none of them took him or his suffering seriously.

In the county council’s independent investigation it was found that there had been no coordination of the patient’s care among the attending doctors. They also found fault with the sharing and filling in of the patient’s medical records.

At the National Board of Health and Welfare they are highly critical of what has happened and call it “remarkable” that twenty physicians can have missed that the origin of the abdominal pain came from the upper part of the digestive system.

If a gastroscopy had been carried out sooner, the patient may have had a diagnosis months earlier and received better treatment the agency concluded, according to VF.

The agency has now asked the county council to present a plan for how to prevent this from happening again and new guidelines for dealing with patients’ abdominal pain latest by May 20th, according to VF.

TT/Rebecca Martin
twitter.com/thelocalsweden

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09:00 March 23, 2012 by Mxzf
I think we need a patients advocate. A person that does nothing but make sure a patient is treated well through the healthcare system, gets a proper diagnostics and treatment, and translates between patient and doctors. No special education would be needed for it - just someone who's mission is to make sure the healthcare works for every individual.
09:26 March 23, 2012 by Ambre
I woudl sue their ass if it happened to a member of my family! What a disgrace this country is, for everything!!!!!!!
09:28 March 23, 2012 by CJ from Sunshine Desserts
Really scary.....after all the patient is the layman, in principle who`s fate lies entirely in the hands of the medical staff, I doubt whether any doctor will be struck off as the need for medical staff outweighs the requirement to punish thier incompetence. Still the other extreme is the US where doctors are afraid to be sued, we have to assume they have our best interests at heart....what a sad story.
09:45 March 23, 2012 by cindyalder
No surprise to be honest. In fact, I can actually say that the health system here in Sweden is a complete scam. For example, I had a shoulder problem in February, I went to City Akute and the doctor did not even bother to take an x-ray. He just decided to fix it with an inyection of some pain killer. Brilliant! What a job! I still have a bloody pain in my arm!!! So I went to the "same" place again. The same doctor said that I should try now some physio, and "again" no mention of an x-ray, some band to hold my arm still.. nothing... AND MY SHOULDER STILL HURTS!!! So now I will try to pay a private medical insurance that will cost me A LOT but I cannot find another way.. I seriously don´t want to go the same way as this poor sod did... Bless his heart, and his soul.. Bloody doctors in this country!!! Do your job properly!!!! Or bugger off to do some jardening somewhere else!!!
10:00 March 23, 2012 by krrodman
The real problem is hiding in plain sight:

"According to VF, there was a suspicion of lymphoma, but a referral to have a scan, which was written in June, wasn't carried out until October. "

Why should it take 4 months to obtain a diagnostic scan??

These studies have already been done and are well recognized within the medical profession. A doctor taking a medical history and performing a physical exam will get the diagnosis right about 67% of the time. Add basic diagnostic tests such as blood work and basic x-rays and the ability to make the correct diagnosis goes to to over 80%. Add more sophisticated diagnostic tests such as CT Scans and MRIs and the ability to make to correct diagnosis goes up to well over 90%.

One of the doctors tried to do the right thing. He/she realized that the clinical presentation was a little odd. How are abdominal pain and coughing up blood connected??? It is a strange combination of symptoms with abdominal pain coming most often from the GI tract and hemoptysis(coughing up blood) coming from the respiratory tract. He ordered a scan to help sort it out. So far so good. But socialized medicine controls costs by rationing care. In Sweden it take 4 months to get a diagnostic scan. Shameful care.

This is a clear case of Death by Socialized Medicine.
10:18 March 23, 2012 by OUIJA
No kidding! This does not happen in Sweden. O.K. well. It does happen and quite frequently.

To make a very, very long story short, back in July 2010, I started suffering a severe heel problem and cramps in both legs. My wife took me to "akuten" in Karolinska at Huddinge, and guess what. Six stupid "doctors" did not know what the problem was. One woman, even said that "I might have drink too much" (sic). Another said that I might have had a stroke. A third one, an orthopedist, had no idea of anything. It was finally a Chinese student who asked a very simple question: "Have someone measure your blood pressure in your legs?" Wow! My wife said. Almost no pressure in both legs. He sent us to surgery department and a specialist in veins, etc, looked at my legs and the result was: Eight months in and out from the Karolinska hospital in Solna. Eight months of stupidities where they had to perform three by-passes in my left leg and two more in my right one, until finally, a specialist (a woman) took care of me and now I am still under surveillance, because my legs are not fully recovered and she, my guardian angel, does not want me to loose my left leg

The professionalism of the doctors taking care me, was that I was sent four times back and forth to a rehabilitation center (Stockholm Sjukhem) where they just wondered how it could be possible that I was considered ready for rehabilitation, when the last time I was there only 8 hours, because I was bleeding and had over 39 degrees fever.

Something should be done, because if nothing is done, the majority of the so-called doctors will keep on prescribing patients the Swedish miracle pill: Alvedon. Yes, the one that cures cancer, headaches, fever, HIV/Aids, ghonorrea, stupidity, senility, ebola, polio, Creutzfeldt-Jakob Disease, diabetes, asthma,

I do not wish any of the posters to fall into the hands of the many, many stupids I faced at the Karolinska.
10:21 March 23, 2012 by libertarianism
Re #1, Patientnämnden is supposed to act as some kind of advocate. But like most other worthless state employees, they sit on their arses while people die.

Personal responsibility does NOT exist. No one is held accoutable for their actions. State workers get paid the same no matter how many lives they ruin. No matter how many people they kill. Same story, different victim. It's horrifically grotesque. An apathy epidemic.

Veterinarians and their staff do an immensely superior job. No dog-cat-horse gets passed around for months until it dies. No pet owner in their right mind would pay a vet who was so grossly incompetent, with a nasty attitude to boot. They would be out of business overnight.

My thoughts go out to this poor man and his grieving friends and family...
11:15 March 23, 2012 by stevo1
I think you have to realize that doctors use a system of deduction to try to give a solution to sickness.

It's very easy to criticize a profession having no knowledge or experience in it.

This story is not new, it happens in every country of the world.

Plus doctors in Sweden have mandates from government to reduce expenditure.

hey, if everyone lived their lives in a healthy way, most wouldn't need a doctor in the first place, more often it is the ghosts of the past that haunt your health in the senior years.

How about individuals take responsibility for their lifestyle choices and stop blaming other professions?
11:26 March 23, 2012 by gabeltoon
Another report of how bad the system is in SWEDEN. Come over to SCOTLAND and see how the health system works here.
11:29 March 23, 2012 by Templeton
Coming from USA to reside here in Sweden, I have great concerns about your health system from all the horror stories I have been reading.

First off I have worked in the medical field for 10 years in the USA in a top Cancer center as a medical assistant and eventually a secretary to one of the top Lung Cancer specialists known world wide.

Symptoms of coughing up blood and loss of appetite is a no brainer for even a lay person that something serious is going on. A broken rib would not induce loss of appetite, and coughing up blood, if was associated with a cracked rib, one would assume it punctured an organ.

Not feeling any better, then prescribed laxatives and painkillers?More intense testing should have been ordered such as a PET whole body scan since his symptoms were of a serious nature and never resolved. I feel for the family for their loss, but regardless of the lack of medical expertise this gentleman was probably beyond cure.

My first experience seeking medical help to have an emergency prescription filled for my asthma, I was a bit shocked at the lack of simple hygeine practices in the medical setting. I was sitting in a waiting room full of adults, adolecences and children all on a sick visit but not one bottle of acholol based hand rub in the room.During flu season no less!! It is common practice in USA to have these bottles placed strategically about the waiting room, exam rooms, hospital and elevator entrances. Are alcohol-based hand rubs really effective? There are published studies prove alcohol-based hand rubs effective in reducing the number of bacteria on hands and recommened by the World Health Organization.

Adults, especially children, were coughing without covering there mouths and not asked to put a mask on so they do not infect others in the room.

Since I have very bad lungs and susceptible to infection, I was mortified that I could not find a box of masks in the waiting area for those who preferred to protect themselves from either infecting others or getting infected.

I am terrified that I might need an ambulance one day, an be refused because of some triage nurse that knows nothing of my medical history and my life is put into their hands. Any symptom could interpreted as minor, but if I am calling for an ambulance, obvouisly I feel my life is in danger and need medical assistance right away. I do however find many factors in your health system to be much better than the USA and I have much to learn living here.

As a patient it is our responsibility to convey with strong convictions our health concerns to our medical staff, and if not satisfied by the response then we must insist and persist until the health problem is solved for we know our bodies better than anyone, and have built in warning systems that should not be ignored.
11:55 March 23, 2012 by cattie
Excellent posts by most commenters. Defender of the system @"Stevo1" seems to be representing Socialstyrelsen.

He saw 31 doctors (plus any tests), surely getting the resouces for a quick follow-up would have been LESS expensive.

Any Swedes who have been enjoying basically good health for the last 20 years will be in for a big surprise when they (or a loved one) is subject of current healthcare system. I guess about 67% will get diagnosis and care in a timely way--as long as they are not difficult patients and are accused of being drunk, on drugs or ungrateful.

Enough people will survive for re-election, nothing will change. Since there is currenly no system with enough resources or consequences to enforce the standards already in place.

A patient OMBUDSMAN, with enough staff to get action, would be an excellent way to have a recourse of accountability. They should have referral to lawyers, too. In fact, I have an idea how they can fund the ombudsman. Maybe if the law changed to allow punitive damages against hospitals and wards for such malpractices. Many there would then be a motive for enforcing best practices..
12:18 March 23, 2012 by EP
It took 4 months for the referral to be done because June is the start of vacation month in Sweden. It's simple ...
13:34 March 23, 2012 by jope09
Am I the only one being annoyed by the misinformation in this text - Värmland is in no way in the "northwestern" part of sweden, have you seen a map? Mid-west or even south-swest would be a better description. Just sayin'.
14:52 March 23, 2012 by OUIJA
I do not care where Värmland is. It can be if Afghanistan. The core of this story is the lousy way Swedish so-called "doctors" are taking "care" of sick people. That is all.

But to please @jope09, # 14,

Värmland's location is

Equirectangular projection, N/S stretching 199 %. Geographic limits of the map:

N: 61.20° N

S: 58.60° N

W: 11.60° E

E: 14.70° E

Now, let us please go back to the subject. I am one of the many angry people in Sweden who would like to discuss the problem and not to argue about Värmlands position.
16:09 March 23, 2012 by libertarianism
Ouija,

I'm sorry they hurt you. They hurt me too and countless others. I've cried most everyday for three years for what they did to me. My life is forever changed. I hope we who survive can help save others...
16:28 March 23, 2012 by OUIJA
#16 @ libertarianism

Thanks for your words. We complained to Socialstyrelsen, and it took 18 months for a stupid "expert" in Uppsala, to come to the conclussion that my treatment was "OPTIMAL", but that the communications wer "NOT OPTIMAL". One more of the Swedish "experts" opening his mouth without even having called me or my wife to hear the other side of the story. The real one. Now, we wrote another complain questioning this jerk on many things; one of them is the fact that he never contacted. He came to his conclussions by only reading his colleagues explanations.

The "not optimal" communication was written by him, only because we wave proofs (a tape and an e-mail) in which to top

"doctors" admit that the way they "took care of me" was not really

good.

Do not cry if you still can see the sun one more day in your life. My train is around the corner, but in the meantime it reaches my stop, I will keep on enjoying every second of my life with my beloved, beloved wife and my two or three friends that I have. You know, @libertarianism, you know who your friends are when you are sick or in jail.
22:53 March 23, 2012 by Radhus
@ OUIJA

I hear you. I've also had to encounter them at Huddinge too. I hope you are feeling better soon. I understand your frustration. I was at Akuten six times before I gave up and went back to my country where I was taken seriously the first time and was able to get adequate care from the beginning.

@ Stevo1

I agree with you to a certain extent, but not all medical problems are the result of people not looking after themselves. I've known people in my life who eat well, exercise, don't smoke, etc but still get heart problems, cancer and other ailments. Even asthma, migraines or impacted wisdom teeth don't always occur because one neglects their health. Many things are hereditary or are even caused by other people, such as passive smoking. Other things are just unexplainable.

Regardless of the cause to one's sickness and/or pain it should be the right of every individual to seek healthcare in order not to be sick and/or in pain, don't you think?
08:55 March 24, 2012 by cogito
OUIJA and libertariansim

The pain Swedish healthcare caused you is scandalous. I have heard many similar accounts from victims of negligence and indifference. Swedes have been trained to bear up and shut up. Thank you for speaking out.

Swedish healthcare is unhealthy and uncaring.

Fans of Obamacare: read and heed.
12:35 March 24, 2012 by Borilla
For all the people criticizing the Swedish system, do not be fooled by the claims of the US "private" health care bloviators. In the US "private" health care is no different. It just costs more. And the "private" health insurers and HMO's force doctors to avoid "expensive" treatments; "expensive" being any amount beyond a few dollars that an untrained or under trained adjuster at a giant health care insurer claims is not accepted treatment. Check the record and find how many suits against health insurers result from their denying life saving treatment for patients and then fighting lawsuits until the patient dies and no longer needs the treatment. And the "private" doctors have no difficulty seeking government aid in asking for the passage of laws that prevent patients from suing. Medical malpractice lawsuits in the US are the only thing standing between the patients and complete disregard of their proper care.
12:55 March 25, 2012 by cogito
Malpractice litigation is a large part of the reason for high cost of medical care in the US. Yet Obama refused to include tort reform in his 2,000-plus page obamacare bill. This is because he takes big bucks from trial lawyers.

While I deplore frivolous lawsuits, Sweden needs to have some sort of malpractice litigation, if only so that the many victims (see OUIJA and libertarianism #7#16) of the non-health non-care system could at least see the negligent and incompetent held accountable.
18:44 March 25, 2012 by cattie
Before I lived in Sweden, while working in the USA I deplored the lawsuits lotteries and was for rigorous tort reform. After a couple years in Sweden, I somewhat moderated my view. What I had not seen in USA was how much that contigency fees and punitive damages in particular served as an method of enforcemet of the law. If there is no remedy, professional standards and laws are just idealist guidelines.

So, a middle way would be a certain level of punitive damages, enough to make it unprofitable for government or business to injure and kill people. To control for the lawsuit lottery problem, have the bulk of the punitive damages go to regulatory enforcement or an independent ombudsmans office for consumer or patientäs rights or watchdog organizations. This way the resources are put into correcting systemic problems.
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