Today is World Tuberculosis Day, and Penningtons Manches is supporting the campaign to recognise the relevance in the UK of a disease which has a higher prevalence in areas of London than developing countries like Iraq, Libya and Yemen.
The firm’s clinical negligence team is well aware of the risk which tuberculosis (TB) continues to pose in the present day, particularly when immuno-suppressant drugs are administered for treatment of other illnesses. To improve patient safety, the medical community must increase its understanding of the condition, ensuring patients receive adequate checks and that risks are managed accordingly.
TB is an infectious disease which can be cured but, if left untreated, can prove fatal. It is caused by a bacterium called Mycobacterium tuberculosis and is spread through inhaling tiny droplets from the coughs or sneezes of an infected person. TB mainly affects the lungs but can have an impact on any part of the body, including the glands, bones and nervous system.
Typical symptoms of TB include:
The NHS recommends that individuals should see a GP if they have a cough that lasts more than three weeks or if they cough up blood.
While TB is a serious condition which left untreated can prove fatal, it can be cured with correct medication. New NICE guidelines from 2016 state that ‘if clinical signs and symptoms consistent with a diagnosis of tuberculosis are present, then treatment should be started without waiting for culture results’.
Clearly, it is therefore important that, if there is a suspicion of TB, steps should be taken to treat it. If not, the disease can prove fatal. Sadly, Penningtons Manches has experience of dealing with cases where patients have died due to the failure of doctors to treat TB on the basis that they did not have test results to confirm the disease despite clear clinical suspicion that it was present.
Unfortunately, there also continues to be a misconception that TB is an active disease which produces immediate symptoms. This is not correct. Some people are unaware that they have latent TB.
In some patients, a defensive barrier is built around the infection and TB bacteria lies dormant. This latent TB can spread if the defensive barrier later fails, meaning that TB can spread within the lungs or develop in other parts of the body.
Accordingly, the prescription of immuno-suppressant antibiotics such as Infliximab and Adalimumab, can present serious risks if not managed correctly. Such medication can be prescribed for conditions like ulcerative colitis and it is therefore of vital importance that there is an appropriate discussion regarding the risks of TB when using these drugs and tests are carried out prior to them being administered. Patients should then be monitored and consideration given to the fact that any latent TB may become active due to the defensive barrier around the TB infection failing.
Unfortunately, Penningtons Manches is currently representing a family who lost a loved one as a result of failings on the part of healthcare professionals to investigate, diagnose and treat TB appropriately after the prescription of immuno-suppressant medication for severe ulcerative colitis. Accordingly, he did not receive timely treatment and sadly passed away. His death could have been avoided had due care and attention been given to the interplay between immuno-suppressant medication and TB.
Emma Beeson, an associate in the clinical negligence team at Penningtons Manches, notes: “I have dealt with a number of cases now where relatives have lost a loved one due to a failure by healthcare professionals to treat TB appropriately. It is upsetting and frustrating to deal with these cases knowing all too well that TB is a condition that can be cured with timely treatment. World Tuberculosis Day is an important day in the calendar to remind people that TB is not a disease that has been eradicated from the UK and is very much an issue that people need to be aware of.”
Cases involving a failure to diagnose and treat tuberculosis, particularly miliary tuberculosis, are quite specialised. If you have any concerns about the medical care provided to a member of your family, please visit our misdiagnosis page for more information.