Clinical Negligence Successful Case Study:
Mrs S noticed a lump in her right breast. The area around the lump was visibly indented, as though the lump was pulling the skin in towards her chest. She discussed her concerns with her husband who examined the lump and advised her to visit her GP. She held off making an appointment because she didn’t believe it would be anything sinister, particularly as she was only 40 years old.
The lump remained and Mrs S attended a GP appointment. She explained that she had noticed a lump a few months ago which she and her husband were concerned about.
The GP examined her in the presence of a chaperone. Her arms were by her side and he felt along the bottom of each breast. The examination only took a few seconds. Mrs S hadn’t had a breast examination before and she didn’t know what to expect. The GP advised her that he was unable to feel the lump and that she had nothing to worry about. He did not ask her to point out the location of the lump. Mrs S was concerned because the right breast was clearly different to the left and the indentation was obvious, but was told that she had nothing to worry about.
Mrs S was upset that the GP had dismissed her concerns and her husband advised her to seek a second opinion. She felt as if she couldn’t ask for another opinion because the GP was a professional and he had assured her that there was nothing to be worried about.
Mrs S tried to forget about the lump and to get on with her life. She was a wife and foster parent who was busy with family life, work and studying. Her husband kept telling her to go back to the GP for a second opinion. She was reluctant because of the first appointment and it was 7 months before she returned.
She saw a different GP. This time the examination was very different from the first one. She was examined with her arms by her sides and then above her head, the full breast was examined and her armpits were checked. She was asked to lie down and the process was repeated. The GP referred her to the breast clinic and she received an appointment within 2 weeks.
A Consultant at the breast clinic carried out an examination which was very similar to the recent GP examination. The lump was identified and she underwent a bilateral mammogram and a bilateral ultrasound scan. She received the results of the ultrasound scan immediately. She was informed that they had found a cyst and something else and a biopsy was carried out the same day.
Mrs S returned to the hospital 2 days later. She was informed that the lump was a tumour. She required surgery to remove the lump and a lymph node biopsy. Surgery took place 2 weeks later. She was advised the cancer had spread to her lymph nodes. She required chemotherapy and radiotherapy. She also had a complete mastectomy and reconstruction of her right breast.
Medical expert evidence was obtained from a GP who concluded that the examination carried out by the first GP was unsatisfactory as a result of which there was a 7-month delay in diagnosing the cancer.
Expert evidence was then obtained from a Consultant Surgeon in Breast Disease who concluded that the lump was present at the time of the first GP consultation and was clinically detectable. He concluded that the 7 month delay in diagnosis had not had an effect of the immediate treatment required, but had resulted in an increase to the extent of the surgery required, and a 6 year reduction in life expectancy.
The above was formally put to the Defendant, but it was denied both that the examination was substandard, and that, even if it was, it had caused any harm. Therefore court proceedings were issued and the parties agreed the timetable of the steps to trial.
Witness evidence, including that of the chaperone, was exchanged. At that point, before the exchange of expert evidence, the Defendant made an offer of £20,000.00. Negotiations commenced and the case was concluded when Mrs S agreed to accept £40,000.00 in full and final settlement of her claim. No admission of liability was received at any point during the claim.
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