Son of Dr Watt patient who died in 2002 questions reliability of two diagnoses his mother received

Colin Armstrong holding a photograph of his late mother, Ruth Armstrong.

Colin Armstrong holding a photograph of his late mother, Ruth Armstrong.

THE son of a deceased former patient of Dr Michael Watt has questioned multiple diagnoses his mother received in the final years of her life.

Dr Watt, a former Belfast Trust (BHSCT) neurologist, diagnosed Ruth Armstrong as having a form of epilepsy in February 2001, the month after she collapsed.

Following her collapse, Mrs Armstrong spent five days in the Royal Victoria Hospital where she received the epilepsy diagnosis. She subsequently saw Dr Watt as an outpatient.

Mrs Armstrong's son, Colin, was with her when she collapsed in January 2001.

Colin Armstrong told The Detail: “My mother fell to the floor but got up almost immediately. I think it was a blackout. I don’t believe she suffered a seizure.”

Dr Watt sent correspondence to a consultant gastroenterologist in February 2001, stating that both Mrs Armstrong’s examination and her CT scan were “unremarkable”.

This makes her son question what the epilepsy diagnosis was based upon.

In addition to this, an academic paper called Diagnosis and Management of Patients with Blackouts, published in 2006 in the Heart British Medical Journal, states that transient losses of consciousness may be more often caused by syncope, a disorder of circulation, than epilepsy.

Mr Armstrong added: "My mother had two heart attacks in 1988 and one in 1993, and was on medication for angina when she was diagnosed with epilepsy."

In May 2018, the Department of Health (DoH), commissioned the Regulation and Quality Improvement Authority (RQIA) to examine the medical records of all of Dr Watt’s former patients who died in the previous ten years.

However, the family members of those who died outside of this period were told, if they approached the RQIA, their loved one's medical records would also be looked into as part of the review.

To read about the “confusion and distress” caused to Mr Armstrong over the legal basis upon which the RQIA accessed his mother’s medical records, please click here.

The RQIA confirmed that the membership of the expert panel to review Dr Watt’s deceased patients’ records “has yet to be determined” but that it will include “medical experts”.

Mr Armstrong said: “The review needs to have, not only neurologists, but also people with an expertise in pharmacology because Michael Watt was prescribing drugs to patients, including my mother.”

Following the epilepsy diagnosis, Mrs Armstrong was prescribed anti-seizure medication called epanutin.

An academic paper published in 1983 in Acta Neurologica Scandinavica, a Scandinavian medical journal, states many experts limit the long-term prescription of this drug in the treatment of epilepsy because "clinically significant untoward effects occur" during its "long‐term use".

Mrs Armstong remained under Dr Watt’s oversight, later seeing him in June 2002 after she collapsed again.

Following this, Mrs Armstrong was diagnosed with a terminal brain tumour.

Her son sought the opinion of experts in London whose actions also led him to question the reliability of the tumour diagnosis.

A consultant neurologist from London’s Cromwell Hospital, Dr Kevin Zilkha, sent correspondence to the Royal Victoria Hospital in Belfast in August 2002, writing that he and a consultant neurosurgeon, called Dr Christopher Adams, "agreed that this could still be an abscess" and not a tumour.

Dr Zilkha added that Mrs Armstrong should therefore have had an MRI scan.

However, documentation shows a clinical oncologist from the Royal Victoria Hospital maintained that Mrs Armstrong’s CT scan suggested that the brain tumour diagnosis was “probable”.

A 1989 publication in Heart & Lung, the official journal of the American Association of Heart Failure Nurses, states that 6% of individuals who were diagnosed as having brain tumours, who took part in a five-year study, were found after craniotomy – which involves part of the skull being removed to allow access to the brain – to have abscesses and not tumours.

Mrs Armstrong never had the MRI scan which the London-based experts felt she required.

This makes her son question the type of care she received in the final months of her life until her death, aged 78, in November 2002.

The BHSCT declined to comment on the issues raised in this article.

Of the 2,952 patients assessed as part of the BHSCT neurology patient recall, the report of which was published in December 2019, over 20% were found to have received misdiagnoses.

The report also recorded that a further 329 patients received ‘uncertain’ diagnoses.

Receive The Detail story alerts by email