A lady from Bedfordshire who suffered a delay in diagnosis of breast cancer following a failure by her GP to refer her to hospital has secured damages in an Out of Court settlement.

The patient, who wishes to remain anonymous, instructed specialist Clinical Negligence Solicitor Adam Wright and Matthew Wightman at Setfords Solicitors to conduct an investigation into the standard of care she received.

In mid-2019, the patient discovered an indentation to her right breast and presented to her GP. The GP examined the breast and recorded that there was barely any indentation and diagnosed a minor loss of subcutaneous fat. No follow-up or referral was arranged.

Under NICE (National Institute of Clinical Excellence), a 2 week-wait referral to hospital should have been made for further investigations for suspected breast cancer.

The patient presented to her GP again around 14 months later, now complaining of a lump in the breast at the same location as the indentation. She was attended to by a different GP who made a 2 week-wait referral to the breast clinic at her local hospital, in line with NICE Guidelines.

The patient was examined in the breast clinic where radiography and histology confirmed the presence of breast cancer.

The patient required surgery to excise the tumour, chemotherapy, and adjuvant bisphosphonate treatment including radiotherapy. She also required treatment with Anastrazole and Zolendronic acid.

The patient raised a complaint with the GP in question, questioning whether she should have been referred for further investigations following her initial presentation. She received a response apologising and acknowledging that a 2 week-wait referral should have been made.

Thereafter, the patient continued to have concerns for how her diagnosis and treatment might have been different if she had been referred earlier. She therefore instructed Adam Wright, a Senior Clinical Negligence Solicitor at Setfords Solicitors, to investigate the standard of care she had received.

Accordingly, her medical records were obtained and the GP was asked if she would make an early admission of liability in light of the acknowledgements made within the complaint correspondence, but no such early admission was received.

As such, an independent General Practitioner expert was instructed to report upon the standard of care the patient had received. The expert identified a failure in care on behalf of the GP in 2019 when failing to adopt a high index of suspicion for breast cancer and failing to make a 2 week-wait referral for suspected breast cancer in accordance with NICE Guidance.

Further expert evidence was obtained from a Clinical Oncologist to describe how the patient’s diagnosis and treatment would have differed with earlier diagnosis. He was of the opinion that some of the patient’s treatment would have been avoidable with an earlier referral in 2019. In particular, the Oncologist opined that the patient’s breast cancer tumour would have been smaller with earlier diagnosis and whilst some aspects of the Claimant’s treatment would have been the same, she would have avoided the need for adjuvant chemotherapy and adjuvant bisphosphonates, and she would also have avoided the need for excision of breast skin (a larger incision to remove a larger breast tumour).

In addition, the expert formed the opinion that the patient’s prognosis has been affected, in that her life expectancy had been reduced as a result of the delay in diagnosis, giving rise to a ‘Lost Years’ claim.

A formal Letter of Claim was submitted to the GP, detailing the allegations of breach of duty (negligence) and causation of injury, as supported by the experts.

In a formal Letter of Response prepared by her lawyers, the GP admitted that the care provided to the patient had fallen below a reasonable standard and admitted that a 2 week-wait referral should have been made in 2019.

It was also admitted that that patient would have been diagnosed with a smaller tumour, staged as a “T1” tumour rather than a “T2”, and that parts of her treatment would have been avoided, such as the need for chemotherapy and treatment with adjuvant bisphosphonates, with earlier referral and diagnosis in 2019. It was also admitted that the patient would have avoided vascular invasion with an earlier diagnosis, something which was the source or great worry for the patient.

However, the patient was put to proof that her life expectancy had been negatively impacted by the negligence. 

Upon receipt of the GP’s Letter of Response, further expert evidence was obtained to assess the extent of her injuries, her current condition and prognosis. This included a report from a psychiatrist who recommended treatment to treat the adverse psychological effects that had been caused to the patient as a result of the failure to refer her.

Following receipt of such expert evidence, and review with a specialist Clinical Negligence barrister, a plan was made to enter into settlement negotiations. After multiple exchanges, settlement negotiations resulted in an agreed sum of damages, equating to tens of thousands of pounds, in compensation to the patient for her injuries and associated financial losses.

Upon securing the settlement, the patient said “I hope that by bringing this claim the GP in question has learned from her mistakes and will treat women presenting with similar symptoms much more cautiously before dismissing them. If my claim prevents the same mistake happening to just one other woman, and prevents her from going through what I have experienced, then that makes it all worth it. No amount of money will ever be sufficient to fully compensate me for the worries I have every single day that my cancer might return. I wouldn’t have this worry if my cancer had been diagnosed when it should have been, because I would have avoided vascular invasion. Adam and Matthew have been brilliant and very supportive, I really appreciate all that they have done for me.”