A GWENT widower has settled a four-year battle over the treatment his wife received at Newport's Royal Gwent Hospital before her death.

Bryan Rendell, of St David's Close, Bulwark, Chepstow, has received a five-figure sum after settling out of court his claim against the hospital's trust.

But the 71-year-old said the money was less important than forcing the changes that have been made by the Gwent NHS Trust since his wife Brenda's death in March 2000.

Mrs Rendell, a nurse who worked for both St Anne's and St David's Hospices, was 59 when she died after an operation at the Royal Gwent for her cricopharyngeal mass, a cancerous growth at the back of her throat.

Her husband says she had complained four months earlier of a sore throat and was urgently referred to the hospital by her local GP.

On December 6, 1999, Mr Rendell says his wife saw a registrar who referred her for an urgent barium swallow, a liquid poured down the throat that would show up any abnormality on an x-ray.

Though it was marked urgent, Mrs Rendell had to wait until January 27 for the barium swallow, a delay Mr Rendell claimed was "unacceptable".

Mr Rendell said: "Brenda was in such pain, she was coughing up blood."

An independent review panel in 2001 recommended that barium swallow request forms marked urgent must be given an appointment within 10 days.

Mrs Rendell then waited three weeks to see a consultant about the results of the barium swallow and a further week for a biopsy confirming the cancer.

Mrs Rendell eventually went in for radical surgery to remove the growth on March 15 knowing there was a 50:50 chance of success.

Mr Rendell said his wife's trachea tore during the operation and that she was without oxygen for 15 minutes, resulting in massive brain damage. Two days later, she died.

Mr Rendell claims he was later told it was normal to ventilate both lungs during such an operation in case something went wrong, a procedure that was not taken during his wife's operation.

The trust deny the claim in a letter to Mr Rendell, and say they followed clinical practice. Mr Rendell says the changes at the hospital made since his wife's death overshadow the undisclosed sum he received this week, which he has already put away for his three young grandchildren.

He said: "It has been pain and hurt all the way but I couldn't give in because I needed to know this wouldn't happen to others. I miss Brenda every minute of every day, we'd have been married for 40 years only three months after she died."

A spokesman for the Gwent NHS Trust said: "Mr Rendell can be assured that the recommendations from the independent review have been fully addressed. Rather than prolong the distress for the family, we felt it appropriate to agree a settlement with the family."

WHAT THE GWENT NHS TRUST SAYS:

In a letter to Mr Rendell in January 2001, Martin Turner, the chief executive of Gwent NHS Trust, agreed with recommendations put forward by an independent review panel who looked at Mrs Rendell's treatment.

The trust agreed that:

l Consent forms for major operations should be signed appropriately by trained senior medical staff who can give informed guidance to patients. Mr Turner confirmed this was now trust policy.

l A mechanism should be established to ensure that when reports are returned they are shown directly to the clinician who ordered them. Mr Turner said that such a system had been in place for some time and was being monitored and re-inforced.

l Further efforts should be made to recruit additional radiography staff. The trust said there was a "serious shortage" of radiographers and radiologists within the hospital which "was a major concern to us". Open days were set up to address this problem and attract new radiographers, and a training programme was established.

l Additional consultation appointments should be made so that out-patient clinic numbers could be reduced to allow more time to be spent with individual patients.

Mr Turner said: "We agree and accept that there is a shortage of consultant otolaryngologists within Gwent to support the population served by the trust."

He said that the trust recognised the need to meet minimum standards of care, but it was likely that a "serious shortfall" of consultant staff would continue.

l A review of training services made available to registrars at the Royal Gwent Hospital should be undertaken.

The trust agreed with the finding but stressed that it had to balance training and clinical duties.

But the trust did not agree with the panel's findings that a double lumen tracheal tube should be used to ensure control is maintained over lungs and ventilation should it become necessary to carry out emergency repairs to the trachea as in Mrs Rendell's case.

Mr Turner wrote that the anaesthetist involved in her operation thought the decision to deploy such a tube should be a matter for the anaesthetist involved with each individual patient.

Mr Turner said: "These additional views have led us to challenge the recommendation of the review panel."

His letter said that such a tube would not provide absolute protection against what happened to Mrs Rendell, and that current practice at the hospital was acceptable.