Gareth, a tax director from Tunbridge Wells in Kent, was suffering from testicular cancer. He died of a condition known as bleomycin toxicity, severe lung damage caused by the chemotherapy drug bleomycin that was administered along with other chemotherapy drugs as part of the trial.
Gareth was diagnosed with testicular cancer in July 2006 and commenced treatment at the Royal Marsden Hospital in August 2006. The trial, called TE23, was testing whether a combination of five existing chemotherapy drugs was better at treating testicular cancer than the standard treatment of three drugs.
Gareth's tumour responded well to the chemotherapy, however, on 17 October 2006, he developed a dry cough, a symptom of lung damage, caused by bleomycin. A chest x-ray on 17 October 2006 also revealed changes consistent with bleomycin toxicity. These symptoms were not felt by medical staff in the radiology or oncology departments at the hospital to be signs of bleomycin toxicity and so bleomycin continued to be administered for a further four weeks. Gareth died on 29 December 2006.
Mark Bowman, Senior Associate at Field Fisher Waterhouse, was instructed by Victoria Kingdon, Gareth's widow after she had heard about his work acting for the family of Gary Foster who also suffered from testicular cancer and died after taking part in the TE23 drug trial.
Mark pursued the Royal Marsden Hospital, arguing that if the abnormal findings of the chest x-rays and Gareth's cough had been identified as being signs consistent with bleomycin toxicity, bleomycin would not have continued to be administered and appropriate treatment could have been given. By stopping the bleomycin at this time, Gareth would only have received 225,000 units of Bleomycin, as opposed to the 300,000 units he went on to receive in total. This was important as in one of the largest studies into the effects of bleomycin, itself conducted at The Marsden, the lowest fatal dose of bleomycin was 290,000 units.
It was therefore argued that stopping bleomycin on 17 October 2006 would have prevented Gareth from dying from bleomycin toxicity. It was also alleged that the continuation of bleomycin beyond this date was due in part to a breakdown in communication between the oncology and radiology departments and in particular whether or not the radiologists were even aware that Gareth was receiving bleomycin as part of his treatment.
The Royal Marsden issued a letter of apology to Victoria Kingdon but did not admit liability in the case. At a settlement meeting the hospital agreed to pay Mrs Kingdon a substantial sum in compensation, an award that was approved by the High Court.
Mark Bowman said:
"The Royal Marsden Hospital is renowned throughout the UK, indeed throughout the world, as being a leader in the care that it provides patients suffering from cancer: In this instance, it fell short of that reputation. One would hope that the various departments within such a hospital would work together in a seamless and efficient manner, so that vital information is shared. Unfortunately, this case revealed a worrying breakdown in the system which had devastating consequences for Gareth. It can only be hoped that lessons will be learned from this case to avoid other people having to suffer the same tragedy as my client."
Victoria Kingdon said:
"I feel disappointed that the hospital failed to provide me with an acceptable response in the period following Gareth's death. I wrote to them with my concerns and their reply implied that Gareth's death was statistically acceptable and there was nothing to investigate. I had unanswered questions and am grateful that the legal process has allowed me to find answers to them. My family now has confirmation that Gareth did not receive appropriate treatment and an assurance from the hospital that processes have been changed so that this will not happen again. Gareth was a wonderful father, son, friend and husband, but this is an important part of his legacy to a wider community of cancer patients.
"I am not opposed to chemotherapy generally and would not want anyone having it now or in the future to have doubts about its benefits because of this case. I do think though that there is a contract between a patient and doctor when embarking on treatment. One agrees to take the administered drugs, and trusts the medics to ensure that they will do more good than harm. The Marsden is a fine hospital, I have personally received excellent treatment there, but it cannot rest on its laurels and accept the kind of errors that were made in Gareth's care, which it would have done had this case not been pursued."
Victoria had this to say about Mark:
"When my husband died I spent two years collecting information and letters from the hospital that treated him, convinced that something had gone wrong. I read about Mark Bowman in the newspaper where he was credited for arguing a case similar to ours. The day I handed over all my paperwork to him a huge weight was lifted from my shoulders. He brought order to the stacks of paperwork and chronology to events, he hired experts who helped to identify the errors in the system that had led to my husband's death, and he was always patient and willing to explain every detail. He understood my concerns from the outset and guided the process to reach the outcome I wanted: An apology. Mark has the energy of youth coupled with the wisdom of experience, a potent combination in any profession. I cannot think of a better partner to have had at my side."
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