Case Study
In another major victory for patient safety and accountability, Cian O’Carroll Solicitors secured a €630,000 settlementfor a woman in her 40s who suffered avoidable and harmful consequences due to delayed diagnosis and overtreatment of breast cancer at Cork University Hospital (CUH).
The mother of two first attended her GP in December 2016, reporting concerns about breast asymmetry. Although her GP noted nodularity in the right breast, the referral to CUH was not made using the National Symptomatic Breast Clinic Referral Form, which specifies that women over 35 with nodularity or a discrete lump should be seen urgently; within two weeks.
When she was eventually seen at CUH in March 2017, the records note nodularity in both breasts, but no lump was identified. She was assigned a benign (S2) clinical score, underwent mammography only, without ultrasound or biopsy, and was discharged back to her GP’s care.
By November 2017, she returned to her GP with a large palpable lump and visible breast distortion. Further imaging and biopsies revealed invasive lobular carcinoma.
Expert evidence obtained by this office confirmed clear breaches of both Irish and UK breast cancer diagnostic standards:
- She should have been referred on an urgent basis in 2016 and assessed within two weeks.
- When reviewed in March 2017, she should have undergone a triple assessment (clinical exam, mammogram, and ultrasound), not mammography alone.
- An ultrasound would have detected the tumour, leading to early diagnosis and curative treatment.
The delay caused significant harm. The cancer progressed, resulting in additional and more aggressive treatment, including axillary node clearance, radiotherapy, and chemotherapy. The plaintiff subsequently developed lymphoedema, a permanent and disabling condition that could have been avoided.
The case also established a second, separate issue of overtreatment by CUH following the eventual diagnosis. Expert evidence confirmed that the hospital carried out unnecessary axillary clearance and supraclavicular radiotherapy, contrary to the HSE’s own treatment guidelines.
Despite strong expert support, both the HSE and the GP initially defended the claim. The HSE argued that ultrasound was not clinically indicated in 2017, while the GP contended that triage decisions rested with the hospital. These positions were ultimately unsustainable.
Following mediation and prolonged negotiation, the case was settled for €630,000, with the defendants paying all legal costs.
This settlement recognises the significant pain, loss, and harm caused by the failure to adhere to national diagnostic standards, as well as the lasting impact of avoidable, excessive treatment. It also reinforces the vital importance of early, accurate breast cancer diagnosis and careful adherence to clinical guidelines.