The third complaint

Derde klachtAbout the last of the complaints I wrote already more in this blog, especially because it seems to be such an unknown phenomenon.

The third complaint was “in 2013 were the indicators for the presence of a tumor in the abdominal cavity, namely an increased abdominal size and protrusion of the navel, not as such recognized”.

In fact I noticed already in 2012 that the size of my belly slowly began to increase, and the belly button somewhat began to bulge. This protrusion (“Sister Mary Jospeh’s nodule”) is an indication of the presence of cancer, and I stated that this symptom should be directly linked with the possibility of a GIST. This visually very clear condition however, was not recognized. But in my opinion the nodule together with the thickening of the body made clear that tumors were for a long time present, at least since early 2013.

The respond of the doctor was that there was in the reports of the verification visits no mention of a swelling around the navel. The first time complaints were reported was in June 2013 when an abnormality was detected during an ultrasound examination. Then it was decided to produce a PET-scan and discuss it in the regional oncological meeting. As this would only take place in September they had contacted in August directly with the Department of Oncology of the Radboud UMC. At which time the PET scan already had showed that there was a recurrence of GIST in the abdomen.
And also that I reported in June 2013 for the first time a abdominal discomfort, namely a sensitive genital area. But that no abnormalities were found on physical examination of that area (in hindsight also notable because afterwards, in November 2014, at that same place it was needed to remove surgically a tumor of about 95 mm).

I responded by saying that at the first tumor in 2010 the protrusion of the navel certainly was not present. And that I only in the spring of 2010 detected a substantial increase in abdominal girth and that in the same period the nodule developed. Because there were no physical symptoms or abnormal blood values and also the echografisch- and X-ray examination of the thorax gave no reason to worry, it was assumed by me that it was caused due to too little exercise.
I also pointed out that this Sister Jospeh’s nodule occurs at 1-3% of all cancer patients and is associated with poor prognosis and multiple peritoneal metastases. And that should have been reason enough to conduct directly a further investigation, especially because I had cancer before. This condition was however never noticed in the regional hospital and only recognized afterwards in the Radboud UMC.

The complaints committee then however found that  over the period August 2012 to June 2013 there were data missing in the medical record. And that the versions of the parties relating to the time of the occurrence of the bulge at the navel diverged.
They studied the footage then themselves and found that no visible deviation of the navel was visible at the ultrasound images of 2013. And therefore they could not determine whether the complaint was valid.
But they also noted that there had been no entries in the medical record about the consultations and observations in the period of August 2012 to June 2013.
On this basis, the committee concluded that the doctor had failed to provide the filing of the research findings and the considerations that were made on that basis. And for that they considered this complaint also as founded.

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