A mum-of-three who died of terminal cancer spent her last years in agony after the wrong end of her bowel was stapled closed during surgery. Tracy Cliff, 67, from Tiverton, Devon, passed away in July 2023 of terminal rectal cancer.
During an operation a year earlier, surgeons stapled the wrong end of her bowel shut, leaving her in pain for five days before she had to undergo a second major surgery to correct it. Devastating diary entries read by her daughter, Jade Farrow, 40, the day after Tracy's death, saw her write: "I don’t want to leave this world; I don’t want to leave my girls."
Tracy later declined to have combined chemotherapy and radiotherapy in favour of just radiotherapy, because she had already been through so much pain following the surgical error that she could not face the combined treatment. Jade pursued a successful legal claim for the surgical error following her mum’s death.
Settlement and admission of negligence
The case has now settled for £10,000 after Royal Devon & Exeter NHS Foundation Trust admitted negligence over the surgery, but disputed that the error affected Tracy’s subsequent cancer treatment and prognosis. Jade, a carer, said: "What upset me the most about mum’s case was how long she was left in pain before they identified what had happened.
"I had her calling me in tears because she was in so much pain, but I read her notes and they were saying she was at pain level two. I'm not a medical professional, but the first time I spoke to her I knew something was very wrong.
"I still struggle to understand how a whole team of medical professionals didn't. I didn't want it to be an apology letter and then forgotten. It was never about the money. I wanted people to actually think about how it had taken so long to recognise what had happened."
Details of the surgical error
During an operation to fit a colostomy as part of her rectal cancer treatment in March 2022 at Royal Devon and Exeter Hospital, the wrong end of Tracy's bowel was stapled closed, causing a complete bowel obstruction. This went undetected for five days as Tracy suffered pain and vomiting.
She underwent further major surgery, later described by expert evidence as "entirely avoidable", and her recovery was further complicated by hospital-acquired pneumonia. She also required a nasogastric tube and further tests.
Her oncologist had told Tracy that the combined treatment offered an estimated 60% chance of controlling the disease, which could have helped manage her symptoms and potentially given her more time with her family. She instead chose radiotherapy alone, which her oncologist advised was the next-best option for controlling her symptoms if she did not want to undergo the combined treatment.
Impact on treatment decisions
Jade said her mum had been left in so much pain following the surgical error that she could not face the side effects of the combined treatment. Tracy wrote in her diary that she wanted to speak to her doctor about changing her mind, but had already received the maximum lifetime dose of radiotherapy by then.
Jade said: "I read the diary the same night she died, when I came home from the hospice. It absolutely broke my heart that she regretted it because I knew she would."
Tracy continued writing throughout the final months of her life. In one entry, she wrote: "I have all I want and need, I see my girls loads and I’m mostly happy and in a fantastic, upbeat mood. I think I will go smiling." But in another, she wrote: "I am getting more and more anxious as each day goes by. I don’t want to leave this world; I don’t want to leave my girls."
Jade turned to Veritas Solicitors to investigate what had happened to her mum and bring a clinical negligence claim. She added: "The thing that hurt most was that the hospital never accepted that the delay and everything that followed could have influenced Mum's treatment decision.
"Mum was such a lovely, warm, family-centred person with a wicked sense of humour. We were incredibly close and I lost my best friend as well as my mum.
"I could speak to her about absolutely anything and she always told me she was proud of me, even when I was at my lowest. Even knowing she was dying, she was determined to wring every drop of joy out of the rest of her life."
Her sense of humour never left her either. She even insisted on ‘Girl on Fire’ by Alicia Keys for her cremation. "It was tasteless as hell, but she insisted on it," Jade said.
Legal and Trust response
Amina Ali, partner and head of clinical negligence at Veritas Solicitors, said: "By the time Tracy’s surgical error was identified, five days had passed and she needed another major operation which expert evidence found was entirely avoidable.
"For someone already facing treatment for terminal cancer, that was an enormous amount to go through. Tracy still had major decisions to make about her cancer treatment after leaving hospital.
"Jade has always believed that what her mum went through played a part in the choices she made afterwards. Although the Trust did not accept that, it was an important part of the case and something we felt needed to be properly investigated.
"The admission of negligence answered one part of the case, but Jade still wanted to understand why the error wasn't identified for five days and what followed from it. A settlement brings the legal case to an end, but it shouldn't mean those questions are forgotten."
A spokesperson for Royal Devon University Healthcare NHS Foundation Trust said: "The legal claim in this case has been settled, and an admission of sub-standard care was made, and an apology provided, as part of the Trust’s response to the allegations.
"We recognise that on this occasion our care was not as expected, and we are very sorry for the distress that this caused Ms Cliff and her family."
