NHS misdiagnoses woman for 23 years

A woman who was called lazy because she fainted during exercise is recovering after an operation to repair a hole in her heart that was described by cardiologists as one of the biggest they had seen. Despite Louise Banks’s suspicions that she might be suffering from a heart problem – which appeared to worsen dramatically when she tried to exercise – doctors repeatedly misdiagnosed her condition throughout her teenage years. Ms Banks, now 23, even resorted to joining a gym to prove that she was not lazy, as her school PE teacher claimed. While running on the treadmill she discovered that her heart rate went down instead of up.

However, it was only this January, seven years later, that her condition was finally identified after a new GP recorded an irregular heartbeat during a 24-hour monitoring test. The scan revealed a tear 4cm (1½in) long in the partition between the right and left side of her heart that enlarged when more blood was being pumped through. The result was lack of oxygen in the blood reaching her brain, causing her to faint. The condition could have killed her at any time in the previous 23 years.

Heart surgeons at Southampton General Hospital have now repaired the gap. She has been left with no lasting effects apart from a 25cm scar on her chest and a temporarily enlarged right side of the heart. Ms Banks is now back at her home in Exeter, Devon, with her partner Matthew Folland, 30, and their son Ben, 4, and is looking forward to catching up on all the things that she could not enjoy as a teenager, including sports and dancing. She said: “I always knew there was something wrong because I could feel my heart start and stop like a baby wriggling in my chest. I’m looking forward to my new life. It will be great to be able to dance with my friends without collapsing.”

At the age of 8 she was described as a “fainty child” after passing out at school. When it happened again she was told that she was epileptic. At 14 she complained of having palpitations up to 70 times a day. At 16, fed up with the taunts, she joined a gym. Her condition was once again misdiagnosed when she complained that her heart rate was falling instead of rising as she tried to work up a sweat. When she was 19 she almost died in childbirth when her heart started fluttering.

An ultrasound test revealed an atrial septal defect, or hole in the heart, between the two main chambers, or atria. Cathy Ross, a senior cardiac nurse with the British Heart Foundation, said that a hole in the heart just 9mm long was considered large and Ms Banks’s was more than four times that size. Mrs Ross said: “She is incredibly lucky. I’ve never heard of anyone having a hole in their heart that large.”

Ms Banks does not harbour any grudges against the doctors who misdiagnosed her condition. She said: “I don’t feel angry with the doctors for missing it. I would rather have been operated on now than 23 years ago when science wasn’t so advanced.”

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Staff flee rotting Australian public hospital

ROYAL North Shore Hospital was in such decay that the floor of its medical records room collapsed and specialists were so demoralised they were fleeing to the private sector, leaving the public health system on the brink of breaking down, a senior doctor has told an inquiry.

The hospital's professor of medicine, Stephen Hunyor, told a public inquiry yesterday his cardiology department went a year without air-conditioning - which, he said, ruined experiments because of high temperatures - and staff complained for four years about poorly functioning toilets. "We've had bricks falling from the main building, we've had a floor collapse high up in the building where the medical records are being stored," he said.

Professor Hunyor, a cardiologist staff specialist who has been at Royal North Shore for 33 years, was giving evidence at the special commission of inquiry into acute care services in NSW public hospitals. He said doctors had "review fatigue" and the inquiry was the last chance to fix problems in the system before it was too late. "Your commission of inquiry is the last stop before some really bad outcomes," he said.

There was an atmosphere of "secrecy" over the $702 million Royal North Shore redevelopment, which would not have enough specialists anyway if the exodus was not stemmed before it was built in the next five years. "Morale is a crucial issue here at the moment and I think it's true to say many of the good specialists are fleeing to the private system," he said. "It's so easy now for these dispirited, demoralised specialists just to say it's all too hard and move to the private sector where they can earn substantially more money."

Executives at Royal North Shore did not last for more than 18 months, causing "administrative Alzheimer's", he said, describing the lack of corporate knowledge as "very dangerous".

Clinicians were constantly subjected to "mindless cost-cutting", while money was wasted on consultancies and plugging staff shortages for which bureaucrats remained unaccountable. "We see $30 million spent on locum people being flown, sometimes from New Zealand, to work in the emergency department for a weekend and being paid large sums," Professor Hunyor said. "We are very concerned that the doctors have no power, no influence in substantive decisions on the operation of their hospital and the medical system." He said specialists were expected to develop clinical services plans without knowing what facilities they would have at the new hospital.

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