The complaint to companion careMy address
For the attention of companion care services limited and for the partners of/ vets in charge of ,Chippenham companion care vets practice. This is an official complaint due to the fatal miss diagnosis and incorrect medical advice that directly lead to the unnecessary and in all probability preventable death of Lilly my 8 month old kitten who was entrusted to you for medical attention, diagnosis, treatment and prognosis .
On Saturday 21st June 2014 I contacted you requesting an appointment as I had observed Lilly gaging the way many cats do if they have a fur ball. Then sometime later she was seen vomiting blood gaging and her breathing appeared to be restricted/shallow and sounded raspy.I checked her air ways and could see no obvious obstructions or cuts that could have caused the bleeding . Concerned as to what had caused such, and fearful of where the bleeding was from and of the risk her breathing could get worse I sought medical help. As she had previously been to you and as you were one of the only vets actually open on Saturday afternoon with full equipment I did not hesitate in contacting you as if there was a problem. I was confident treatment would be administered without any delay or need to transfer her or wait for a surgery to be opened up should such be required.
Initially I was told I could bring her in later that afternoon, as that when an appointment was available . Shortly after ending the call I was called back and told the vet had asked if I could bring her in sooner which was a relief as it meant treatment would be received sooner if needed
After arrival I booked Lilly in and waited to be seen. When brought into the treatment room I explained to the vet and the assistant with her that ,Lilly was a house cat but that we do have a cat enclosure/cattery in the garden along with a second cat and that the enclosure was full of many different types of grasses for them to play in. I explained that initially I thought she had gagged on some grass or got some caught in her throat/under he tongue and maybe that had made her gag earlier in the day when I had first seen her do such. But having seen her vomit bright pink blood mixed with fluid and that as she was raspy and had been also gaged for air a couple of times. And if you put your hand under her chest she was like a rattily crisp packet. I was very concerned about where the blood had come from as I had never known, or had a cat that vomited blood before.
She explained that cat’s often get grass caught under the palette and that can cause them to reach and gag and bring up some blood from straining to get it out.
The vet listened to her chest looked in her mouth ,felt around her abdomen and took a rectal temperature reading which Lilly reacted too shortly after by having a full non restricted or difficult normal bowel movement not accompanied by any loose or dark stools indicating blood or any evident lighter bloods.
Following this examination she said she Lilly appeared to be fine now and believed anything that may have entered her mouth that could have caused her to choke/ gag had either been vomited up as nothing was present or causing her an obstruction now .Or she had simply swallowed it. When I asked about her sounding like a crisp packet and why she physically felt rattily around her chest when you put your hand under her I was told if she had eaten something it was likely to have irritated her airways. The blood was explained away the same way and having possibly been caused by her reaching and gaging.
At this point the vet said .She could see nothing and that Lilly appeared fine and wasn't gagging now and had not done so during the examination .She said she would give her some pain relief just to make her a little more comfortable and she was happy for me to take Lilly home. And keep her somewhere quiet for a day or two and if I was still concerned I could bring her in on the following day ( Sunday ) if she was still in discomfort they would look down her throat to see if there was any thing there. But there was no need to do it now as she was not gaging any more and had not done so while being looked at . She left the room at this point and I even joked with the assistant that maybe they were right and nothing was wrong. I was just panicking as I had never had a cat bring up blood ,Lilly probably just liked the attention and going in the car.
The vet gave Lilly an injection to make her more comfortable and that was it. When I was about to put her back in her crate I placed my hand under her chest to lift her up, and she cried in pain and gaged and gasped for air. I explained that was what she had been doing on and of, since vomiting and coughing up the blood earlier on and how this was what I was trying to explain to them was happening. And why I was worried she may have a problem with her lungs or chest because she was rattily and gasping .
The vet said she wasn't going to wait and wanted to check her straight away and took Lilly straight into the theatre room .
The nurse/ vet in the theatre room even said are you doing it now? This was a great relief as I was now expecting to find out what the problem was. And for Lilly to have the treatment given ,too help her with her breathing, and have her put right. The vet went of and brought in the consent forms and explained that the cost to check her over and remove any thing that may be in her air ways to be up to about £230. I Was more then willing for this to be done and again emphasised that I just needed her helped and any treatment started so she was breathing fine and the cause of the bleeding found. I was told to come back just before five as they would have examined her by then and monitored her breathing and if she needed further operative treatment or monitoring she may need to go to Swindon over night.
I left and received a call about an half hour later saying the bill currently stands at £330. Her airways were clear and showed no blockage. They had done a number of xrays and wanted to know if I wanted to have at further cost an extra x ray of her intestines done as there was what looked like a little gas /air in her tummy so that may be sign of a blockage in her bowel . I said I did not believe there was a blockage and if they had seen her tummy on the xrays they would surely see her bowel as well already and that she had already opened her bowel in front of us during the examination and had not had any problems with her bowel movements prior to coming in . The air in her tummy was likely due to her gasping and gulping for air was it not .So such test's were unnecessary extra stress, I was told yes that can be the cause. I said I wanted the reason for the rasping sound and the blood she brought up concentrated on. They said they would monitor her for the next hour or so but nothing was seen in her air way and to collect her just before they closed at five. I sat in the car park outside for over an hour waiting for her to be monitored.
When I went in to be told the results of the examination and monitoring I was told by the vet that Lilly's breathing was fine there was no obstruction there. The tube went down really easy. When I asked if they had found the cause of her gaging and bringing up the bright pink blood she said all though nothing showed on the tests as it was bright pink she had probably caused a small cut after getting something caught in throat or from gagging so much but it would be nothing to worry about as there was nothing there now, and she was fine.
She said they had monitored Lillys breathing and she was fine .There was nothing wrong with her and she was ready to come home I was to keep her somewhere quiet for the next day or so. When I asked why she was raspy and breathing shallow. She said cats often swallow little things like insects that don’t show up on test these can cause a reaction such as the gagging and being sick that Lilly had had ,which makes their throats sore.
So cats do change how they breath because they are uncomfortable. She said she would give her some pain relief to take home .But she was happy there was no cause for concern with her air ways. She said she did think Lilly may have or could develop a blockage from swallowing something and that we should keep an eye on her for that .And needed to look out for vomiting or diarrhoea as that would show a blockage and would need an operation. I said I did not believe there was a blockage as her toilet habits were normal and she had even gone shortly after they used the thermometer and any object that would cause a blockage would have shown on the x rays.
She gave me the pain relief for Lilly and the out of hours phone number and said to watch her for vomiting if she did I would need to take her to the emergency vets in Swindon where the could then monitor her better. She said before I left if she was still in discomfort on Monday then to bring her back in to be re seen and that you were also open on Sunday if she had and vomiting or diarrhoea during the day to bring her straight in.
I went to the reception to pay while the vet went to get Lilly. The receptionist asked how I wanted to pay I said I would pay of my card. And as long as Lilly was ok now, and sorted out and not in danger the cost didn’t matter. .She said it was a shame not every one felt that way!
The vet brought Lilly out and even gave me a sachet of gastro intestinal food. I again asked if she was sure she was ok and there was nothing to worry about .She said her chest and breathing was fine .To just look for vomiting and diarrhoea and bring her straight in ,or up to the out of hours if there was, as she believed a bowel blockage may develop.
Lilly was brought home and kept in doors. She had a couple of small drinks and small amount of wet food she was given her pain relief and spent the night in the bedroom with us and our other cat she was sleepy as to be expected following the anaesthetic and pain relief not to mention the stress of it all.The following day ( sunday ) She was given her next pain relief She again stayed in doors and went for a wee normally in her litter tray she did not want to eat but as her throat was ,we were led to believe and following having the tube inserted in it as well ,sore. She had ,had a lot of stress ,and was sleepy from the pain relief we were not to concerned that she was not hungry.
She spent the morning sleeping on the rug and walking around sitting under the table .Her breathing was still the same as it was when we brought her into the vets. And as it was, when you discharged her .In the early afternoon she wanted to lay in her basket so we let her stay there with the door open and sat with her to keep her company. We received a phone call from the vets at around 1.30 pm on Sunday asking how Lilly was I explained that her breathing was still the same. That she had not had any vomiting or diarrhoea and that she was laying quietly in her basket. Had not wanted to eat today and that if she was still like it Monday I would like to bring her back up. I was told that was fine and to watch for vomiting diarrhoea . I then phoned back a few moments later as I realised no appointment had been made for Monday .So I called and made one for 10.45 am.
That afternoon she remained there quietly and her breathing was still raspy and shallow just as it was when I bought her in to you concerned about such and just as it was when you discharged her and told me it was fine she was just in discomfort due to what ever had irritated her throat.
By early evening she got up to go out to the litter tray and went for a wee and then came back to her basket as the pain relief must have now worn of and she appeared to be in some discomfort as she only wanted to stay in her basket and seemed to only be comfortable when on her front so water was offered from the end of the syringe which she voluntary took and liked up. As there had been no vomiting or diarrhoea as we were told to look for straining or toilet problems. We believed under the advice you gave that she was simply uncomfortable and sore and by letting here lay quietly she would recover.As the evening went on her discomfort seemed to increase when she lent on her side. We were not prepared to leave her like such as laying on her side made her wince and breath with her mouth slightly open. We called the emergency vet number and after 3 attempts got through we then took Lilly straight up to them.
On arrival after explaining the initial symptoms that she was presented to you with, the very first thing we were asked was. Could she have been hit by a car or could a person have hurt her.We explained that was impossible as she did not go out.But that she is a very jumpy active cat who jumps about a lot in the cattery. We showed the vets the pain relief you gave and tests you done . She said before doing any tests or full exam that she believed the blood she had brought up the day before had entered her lungs and caused pneumonia. And she would get her on a course of antibiotics and start her on oxygen. She struggled to save Lilly that night, had kept in constant contact with me through out the night. It was however all in vain ,as the damage had been done and the treatment needed given to late because you failed to correctly advise on treatments or diagnose Lilly.
Lilly died an unnecessary painful and totally needless death due to your miss diagnosis and failure to prescribe antibiotics to a cat that had been presented to you after vomiting blood and having a raspy wheezing chest.You instead chose to tell me there was no problem with her breathing or chest and to watch for a bowel problem.
I brought Lilly to you for expert medical assistance treatment and advice something I could not offer her as I do not have the skills or equipment for such you were in detail told what her symptoms were and what my concerns were and specifically asked to find why she sounded and felt rattily like a crisp packet on her chest.
You told me she was fine and her chest was fine saying it was simply due to her probably swallowing an insect and all she needed was pain relief for the discomfort and I was to look for vomiting and diarrhoea as that would show a bowel blockage. How the hell could you get it so wrong.
Lilly could not tell me what the problem was. Or how much pain she was in and such only became truly evident when the pain relief you prescribed wore off. It was this pain relief that masked a real and dangerous condition that was developing. And you’re complete miss diagnosis that lead to her no doubt ably highly preventable death.
Had the bleeding been correctly identified the pneumonia not been allowed to take hold and damage her little lungs and antibiotics or drugs to dissipate any potential fluids in that area prescribed . Lilly would not only have been given the chance of survival and medical treatment ,I had asked you for and sought out when employing you .She would in all probability still be with us. Lilly was a young healthy active cat with many many years ahead of her and due to your total failure to offer correct treatment for the symptoms she was presented to you with, there is no other way to put it, she has paid the ultimate price. And is now dead.
This has not only deeply distressed and upset both my husband ,my self and our children but also caused anxiety and deep distress to our other pets particularly our other cat who is at present walking round the house howling and crying.
When I came in to the surgery on Monday with my daughter .As I did not think I would be able to talk to you by myself with out falling to pieces for an explanation. I was and still am very angry and even more so to find that Lilly's medical notes are inaccurate and do not state she was vomiting blood just coughing blood and blood around mouth. There is no record of her oxygen/ heart respiratory levels which could have shown if there was a problem developing.
I was then told the records show I had declined further treatment which is untrue and inaccurate. I declined an extra x ray on her bowel ,as I felt such would be looking in the wrong area . I wanted her chest and respiratory area concentrated on and treated as I believed that was where the problem was. As she was raspy and not breathing right, and it turns out I was right. You even then went on to try and put the blame on me again by saying on Sunday when you called the records show the owner is going to wait 24 hours before bringing her in. The owner told the nurse who was in the room with you yesterday and confirmed that this is what I said was. Lilly's breathing was no different she was laying quietly in her crate and there had been no vomiting or diarrhoea as I was told to look for but I still wanted her rechecked in the morning if there was no improvement over night. Not quiet as on the notes!
As the medical experts and given her symptoms on Saturday surely when I said her breathing was still the same you should have said if her breathing is still the same its best to bring her up today so we can have another look as we may have missed something. You did not, which again led me to believe I was wrong about her chest and we needed only to be cautious of you being correct and that there could be a risk of her getting a bowel blockage and her breathing was simply due to her throat being irritated.
You told me yesterday when I came in to find out why you allowed a young strong otherwise healthy kitten who was brought into you with the symptoms she was to be, not only to be sent home with out any preventative medication. ie drugs to dissipate any potential fluid or blood accumulation that may build up or antibiotics to prevent infection or pneumonia that may develop from the bleeding and symptoms she had .And was presented to you with. That it not possible to predict a problem that may develop over time!
That is exactly why you are the medical expert and exactly why people come to you because when an animal is presented to you with symptoms .It is your knowledge, expertise ,experience and medical treatments for both immediate and preventative treatments ,for conditions that can and do develop that they are employing and paying you for .
It is strange that you are quick to say you could not predict Lilly would go on to develop the problem she did with her lungs. Yet you did think you could predict she may develop a bowel blockage with no supporting physical signs or symptoms. But the signs and physical symptoms for the lung condition that could develop were ignored.
When I asked why antibiotics or drugs to disperse any potential fluid were not prescribed as preventative measure .Given the bleed and risk or infection or lung problems. You said such may not have helped or saved her any way as the condition developed so quickly . Given the fact that the emergency night vets started her on such immediately that tells you ,there was a chance, even at such a late stage. So had you given her the same chance of life and medical care as requested when brought to you she would most likely still be here.
Again when I question why given her symptoms you could have let her down so badly and incorrectly prescribed and diagnosed her and why her medical notes did not record her as vomiting blood. You told me the emergency report from the night vets where we had taken her. Also showed she and no vomiting or diarrhoea. This then had to be pointed out to you as incorrect as it showed she was presented to you with vomiting blood and difficulty in breathing .But since then. There had been no further vomiting and no diarrhoea. Which is what you told us to look for.!
Had I been informed there was the remotest possibility the bleeding could lead to pneumonia or there could be blood or fluid around her lungs not only would treatment have been requested for such .But I would have wanted her fully monitored for such. Your vet however instead ,chose to tell us despite Lilly's obvious and evident symptoms. To look for a potential blockage in the bowel.
Absolutely nothing on earth you can say or do will ever bring Lilly back or take away the fact that she died and died slowly and painfully .Because you did not correctly assess the condition or symptoms or give a correct prognosis or appropriate treatment for such. And the pain relief you did give, simply masked the underlying and developing condition that was to kill her.
You were employed to give expert medical care and treatment and given a full history of her symptoms. It was inaccurate diagnosis.Inaccurate prognosis.Inaccurate medical advice. Inaccurate treatment and inaccurate monitoring and record keeping of a condition that was highly treatable and curable that killed Lilly. You failed Lilly and you failed us. You did not provide the service, treatment ,care, advice or expertise, as requested paid for and due when your services were employed and engaged.
Although absolutely nothing can,will ,or could ever compensate for Lilly's untimely and unnecessary death. Being left with the financial burden as well as coping with her loss due to your staffs misdiagnosis and incorrect treatment in unacceptable.
Had Lilly been correctly diagnosed treated appropriately and then not responded and died I would have been fully accepting of her treatment and the bills and charges. However ,as it was your misdiagnosis and lack of timely intervention and incorrect veterinary medical advice, that ultimately allowed the condition the killed her to develop. I am not accepting of the services you charged me . On top of these charges you made for medical treatment and prognosis diagnosis that was wholly incorrect. We have also to face the vet charges for the emergency care the was required for no reason other then due to your failure to correctly identify or diagnose the inevitable condition she was to develop, following the symptom she was presented to you with . I say inevitable because as I said to you yesterday I have spoken to an independent vet who said antibiotics should have been given straight away given the symptoms she was presented with and the night vets immediate action was to start antibiotics. . I am requesting that due to your lack of treatment and expert medical advice and care administered to Lilly you reimburse me the full charges of Lilly's medical care and that you cover the cost of her emergency care which was only necessary and became due because of your failure to correctly assess and treat the condition and symptoms Lilly was originally presented to you with..
You assured me yesterday that you would speak to the vet who dealt with Lilly and see why her medical records are inaccurate. And why she was not given antibiotics ect ,and call me back. However at the time of writing this 24 hours after coming in to see you I have still not heard from you.
It is disgraceful enough that Lilly was let down and miss diagnosed by you .And as a result died from a condition what was highly treatable. To find when I brought her home she had fleas crawling on her was beyond disgusting as I could not even then kiss her good buy. To find that you have incorrect records unbelievable. And to still be waiting for answers to the above and to find I am now having to chase you for such, while trying to come to terms with the events of the last few days demonstrates nothing but a total lack of concern and compassion on your part . This is difficult enough with out having to write letters such as this in order to get to the truth.
I would like to hope that you will now deal with the staff who treated Lilly and get the answers the way you said you would. So that this can never ever happen again, as this was totally preventable. I would like to hope that under the circumstances this will be dealt with amicably and with out any further stress or upset. being caused to us.
I am however not prepared to simply sit back and just take her death as an unfortunate occurrence that could not have been handled differently, nor am I prepared to sit back and take on top of the loss of this young kitten who,s life should and could have been saved the expense and the bills charged to me for emergency treatment that was required due to your failure to correctly asses diagnose, treat or prescribe treatment for. When she was presented to you with the signs and symptoms she was. Nor am I prepared to accept that the charges you billed me for following her treatment and examination, as the service and level of service advice and care together with miss informed advice regarding her care is what caused her death. Which means the service I employed you for was not of the level or standard expected , and was inaccurate and proved fatal.
Before needing to make a formal complaint against the surgery staff responsible for Lilly's care and vet in question Silvia Espinola Folguera to the RCVS I have sent a copy of this letter to the address below via email and to Chippenham companion care branch as it was you who treated her . It will be delivered by hand to you at the Chipenham branch ,as I have still not been contacted by you with any answer, and I would like you to have the opportunity to respond to me with answers to the above before I do .
copied via email to:
Companion Care (Services) Ltd
Manor Barn, Kingston Lisle Business Centre, Kingston Lisle, Wantage, OX12 9QX enquiries@companioncare.co.uk
I expect to hear from you with in the next 7 days with an explanation for the above and expect the fees I paid to you to be reimbursed with in the next 7 days and the vets now referrals fees that were incurred due entirely to your miss diagnosis and incorrect treatment and advice to also be settled in full with in 7 days
yours Mrs ----------- |
