Medical negligence specialist Michelle Beckett reflects on the case of Mrs S, where sadly despite her reporting a breast lump and being seen by her GP on 3 occasions, the appropriate action was not taken until the 3rd appointment and it was argued that this negatively impacted on her long term treatment and prognosis.
The facts
Mrs S, a 54-year-old, lady attended her GP with a breast lump. Despite clearly telling her GP that she felt a lump in her breast there was no examination and she was simply reassured that there was nothing to worry about. As she was still concerned she returned to the GP again reporting the lump around a month later. Although an examination did take place during this appointment, she was again told that this was not any cause for concern. She remained concerned and returned a month later (2 ½ months after the initial appointment) when she was seen by a locum GP who examined her and located the suspicious lump. She was then, finally, referred to her local hospital under the 2-week cancer pathway and the lump was investigated.
Testing identified that sadly Mrs S had stage 3 breast cancer. She underwent a mastectomy and further testing revealed that the cancer had spread to the lymph nodes.
Alleged impact of delay
In her legal claim, it was argued that had the appropriate action been taken earlier then Mrs S would have avoided:
- 2 ½ months of discomfort and anxiety after finding the lump;
- The spread to the lymph nodes increased the risk of future recurrence of the cancer.
Mrs S suffered anxiety and trauma in response to the delay and in particular the future risk of recurrence.
The legal case
It was admitted that there was a failure by the GP to examine Mrs S when she first attended, and that had an examination taken place at this stage then this would have resulted in a referral 2 ½ months earlier. It was also admitted that there was a further failure to refer following the second appointment.
However, there was an argument as to the impact of this delay. Based upon expert evidence, Mrs S claimed that without the delay the cancer would not have spread to the lymph nodes and the fact that the cancer had spread to the nodes increased her risk of recurrence. Mrs S’s expert opinion was that there were 3 nodes affected by the cancer.
The Defendant obtained expert evidence that even with earlier treatment, there would always have been at least one node involved and that Mrs S’s risk of recurrence had not been affected by the delay.
There was a difference in the expert opinion and two experts did not budge in their views. The compromise that was agreed between the parties was that the claim would settle on the basis that the cancer would not reoccur, but that if it did then Mrs S could return to the Defendant/Court for additional compensation in the future. This is known as a settlement on a provisional damages basis.
Michelle’s comment
Sadly, this is a situation that we see all too often and even when people take all the right steps and report their concerns to their GP or healthcare provider they do not receive the right treatment or referral.
The compensation that Mrs S received enabled her to obtain the psychological therapy that she needed to overcome the trauma she suffered as a result of her delay in diagnosis. The main value to her, however, was knowing that should the cancer recur, she would be able to claim the costs of the treatment and care that she would need which had the potential to be substantial.
Early detection of breast cancer is key to a positive outcome, and time is of the essence which makes any delay on the part of a medical professional significant. Whilst nothing can turn back the clock and I hope that Mrs S’s cancer does not reoccur, I am pleased that she will be protected in terms of compensation should the worst happen. Provisional damages are traditionally very hard to achieve, and this shows the importance of having the right legal team (including experts) if you are considering bringing a legal case.
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