A hospital trust has been fined £60,000 over the death of a patient who died following a mix-up with his scan results.
The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust was sentenced at Chelmsford Magistrates’ Court for failing to safely manage scan reports.
Lucas Allard, 28, visited the hospital in March 2019 with chest pains and had a CT scan.
Staff then deemed him fit for discharge.
But a review by a consultant two days later found the wrong test results had been viewed. The correct report showed Mr Allard had a significant abnormality.
He was called back to hospital but shortly after arriving, he suffered a cardiac arrest and died.
The QEH Trust pleaded guilty to exposing a patient to avoidable harm before he died.
Zoe Robinson, CQC head of hospital inspection, said: “Lucas Allard had the right to expect safe care and treatment from the Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, so the trust’s failure to ensure its staff reviewed correct scan results is unacceptable.
“If the trust had identified and addressed the weakness of its system, it could have appropriately responded to Mr Allard’s condition and provided him with the urgent care he needed at the earliest opportunity.
“The vast majority of people receive good care when they attend hospital.
"However, when a healthcare provider puts people in its care at risk of harm, we take action to hold it to account and protect people.
“I hope this prosecution reminds healthcare providers of their legal duty to always take all reasonable steps to ensure people’s safety.”
The trust has admitted it had not ensured safe care and treatment due to its lack of adequate processes to ensure staff reviewed correct scan results, and to ensure results showing abnormalities were appropriately escalated.
Alice Webster, Queen Elizabeth Hospital Acting CEO, said: "On behalf of the Trust, our thoughts and condolences remain with Lucas’s family recognising the memories today’s hearing has likely stirred.
“The Trust accepts and profoundly regrets that there were failings in March 2019. From the outset, we have accepted responsibility and co-operated fully with the Care Quality Commission at every stage.
“The Trust has and had in 2019, a responsible attitude to safe working in all departments, including an appropriate system for induction and training the procedures for obtaining scans, as well as a properly considered, resourced, staffed and supported health and safety management system. This is reflected in the Judge’s finding that the Trust’s culpability was low.
“We have learnt and taken measures to address and close the gaps this case clearly highlighted."
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