A “fit and healthy” 46-year-old man died after London doctors failed to spot a blood clot, the health ombudsman has found.
An investigation by the Parliamentary and Health Service Ombudsman (PHSO) discovered the patient was not tested for deep vein thrombosis (DVT) despite the condition being a risk following his surgery.
The man, whose family have requested that he remain anonymous, had visited A&E at Queen’s Hospital in Romford after damaging his knee playing football and had an operation later the same day.
However, the patient found himself struggling to walk following the surgery so went back to A&E two weeks later, where one doctor questioned if it could be DVT.
An X-ray and blood tests were carried out but two weeks later the man had tightness in his chest and fainted.
His family called an ambulance but his heart stopped on the way to hospital, where he died.
The ombudsman has ruled that the man’s death from a pulmonary embolism was avoidable.
The man’s older sister said he was a “lovely person” and her “rock”.
“As a postman, he knew everybody, and he was very well-liked,” she added.
“At his funeral, people lined the streets to say goodbye and so many people told us about ways he had helped them while on his rounds. He would help people who couldn’t walk very well or who were poorly, that’s the kind of man he was.
“He was so kind to everybody, and I just miss him so much. I don’t think we will ever get over losing him, especially knowing that it didn’t need to be this way.”
The PHSO said doctors at Barking, Havering and Redbridge NHS University Hospitals Trust went against national guidance by not carrying out the relevant tests to rule out DVT.
If detected earlier, the condition would have been treated and would have prevented the fatal pulmonary embolism, the PHSO added.
Ombudsman Rob Behrens said: “This is a tragedy that should have been avoided.
“A fit and healthy man lost his life because doctors failed to carry out the correct tests. That is an injustice to him and his family.
“When mistakes like this are made it is vital that they are learned from so they do not happen again.
“That’s why it’s important to raise concerns when things go wrong. A well-handled complaint that is embraced by the organisation involved has the power to reveal the truth and even create lasting positive change by driving up standards.”
The PHSO has recommended that the trust give the family £15,000, as well as writing to them to acknowledge the failings and creating an action plan to prevent the circumstances from happening again.
A spokesperson for Barking, Havering and Redbridge University Hospitals NHS Trust said: “We are very sorry we failed this patient and we’d like to extend our sympathies to his family.
“We are determined to learn from avoidable deaths and we are improving the way we respond to cases of DVT.
“We’ve made our assessment tool more comprehensive and all patient with plaster casts on their lower limbs are checked for DVT at their fracture clinic appointments.”
