Mencap estimate that over the past decade 74 deaths of patients with learning disabilities were caused or contributed to by "institutional discrimination in the NHS".I am currently representing a mum whose daughter sustained severe brain damage at the age of four and as a result had limited ability to communicate and mobilise. Over time her daughter learned to communicate in a way that her mum, dad, sister and carer understood. 26 years after her daughter’s injury, mum raised concerns about the fact that her daughter had become drowsier and had impaired co-ordination. A CT scan of her daughter’s brain was carried out and the results showed the presence of two tumours. Mum was advised by a neurologist that the tumours were of a type that were unlikely to grow and refused to accept that there was a link between her daughter’s tumours and her presenting symptoms. A further CT scan was taken twelve months later but without the use of contrast. No changes could be seen from the scan. Over a period of three years mum raised concerns with the neurologist about changes in her daughter’s behaviour. She informed the neurologist that she had noticed that her daughter used to be able to eat finger food herself but all of a sudden her hand was shaking and she was having difficulty getting food into her mouth, her temper was becoming worse, her periods had stopped, her epilepsy had stopped and she was suffering from headaches. The neurologist dismissed these concerns and said that these symptoms could be explained by her daughter’s age. Further scans throughout a period of three years were requested but refused. Four years later mum informed the neurologist that her daughter was having difficulty focussing. Mum had noticed that her daughter had stopped watching TV and that her eyes were twitching from side to side. A CT scan was arranged and the results showed that there had been a considerable enlargement of the tumours.Two operations to remove the two tumours were carried out but our client’s daughter died two weeks later. Soon after the operation, the neurologist accepted that the second scan that had been taken twelve months after the tumours were first identified was falsely reassuring and that a CT scan with the use of contrast should have been carried out. This case clearly demonstrates that greater care and attention needs to be given to patients who find it more difficult to verbally communicate the pain that they are suffering. Concerns raised by relatives and carers who look after their loved ones and are in the best position to notice changes in behaviour should not be ignored. Bindya Thakrar is a solicitor specialising in clinical negligence. If you or a member of your family have a clinical negligence enquiry please call our expert clinical negligence solicitors on 0800 916 9049, fill in our short online claim form or email firstname.lastname@example.org and one of our specialist clinical negligence team will be in touch.