If one hospital see 4 cases a year of a rare complication that is hard to detect, they do standard tests. It's not house md. In the usa either. No hospital is going to spend thousands on tests when the usual diagnosis seems to fit. Especially if neither of them were working or paying taxes and 8 mouths were being fed by others because they were too fat or lazy to work.  They probably lived in counsel housing, aka free, and got stipends for food and supplies.  UK docs actually get money for keeping their patients healthy. Bonuses for getting them to lose weight, quit smoking and drinking, etc.  Usa docs get money for giving as many pills and meds as they can while keeping you just sick enough to leach insurance or state funds.