The patient sought care at his health center in 2017. The abdomen was swollen and the eye whites yellow. Referral was written to specialist care at Sundsvall Hospital. There, it was found that the woman suffered from a serious liver disease.

She then went for regular check-ups at the hospital reception. At the same time, the patient repeatedly sought care at the health center due to cough and tense stomach. It was then assessed that it was the liver disease that caused the symptoms.

The patient becomes worse

X-rays made several months after the first hospital visit showed fluid in the lungs and fluid propulsion was inserted.

After a few more months, the patient deteriorated. When new x-rays are made, each was detected in the lung sac. Further investigation is done and several disease states are suspected, including tuberculosis.

Several shortcomings in care

During the care period, the patient deteriorates further and after about one year she dies. Only then is it found that she had tuberculosis, which is also the cause of death.

The investigation that the region has done shows shortcomings in communication, the structure of the journal system and sampling procedures.

Clearer procedures are needed

Among the measures are, among other things, clarified routines for consultation between different businesses, suggestions for improvements in upcoming journal systems and clearer sampling instructions.