Clinical negligence solicitors advise breast cancer patient on claim against GP for delayed diagnosis

Posted: 05/01/2011

London and South East law firm Penningtons Solicitors LLP has settled a claim for Gwynneth Wood against her former GP, Dr Angela Ferguson of Woodlands Surgery in Redhill, Surrey, in relation to her delayed investigation of a breast lump which transpired to be breast cancer. The claim highlights the difficulties for women who seek help from their GPs to allay their fears of possible breast cancer only to find their concerns are dismissed.

Mrs Wood regularly carried out breast checks and in January 2007 she identified a small but firm lump in her left breast when lying down. She arranged an appointment at the Woodlands Surgery and was seen by Dr Angela Ferguson who, according to Mrs Wood's allegation, carried out only a cursory examination as Mrs Wood remained standing and was unable to find any lump. She reassured Mrs Wood and did not advise any further investigation or advise her to return for a further check if she continued to feel the lump.

Over the next few months, Mrs Wood continued to feel the presence of the lump when lying down but she did not return to the surgery as she felt that Dr Ferguson had been firm that there was nothing to be concerned about.

However, by the summer of 2007, Mrs Wood felt that the lump was getting larger and made a further appointment to see Dr Ferguson who made a full examination and made a non-urgent referral for her to the local hospital. The letter referred to a 'thickening' rather than a lump, which had been present for 'a few months'.

On receipt of the letter, the reviewing consultant decided to expedite the appointment and Mrs Wood was seen on 19 September. Following examination, a biopsy, mammogram and ultrasound were ordered and a diagnosis of breast cancer made shortly afterwards. This was subsequently found to be invasive ductal carcinoma. Mrs Wood underwent several procedures and, ultimately, had a mastectomy and chemotherapy.

Mrs Wood was worried about the possible impact of the nine month delay in diagnosing and treating her breast cancer and felt that her concerns should have been taken more seriously at each consultation.

Expert evidence was obtained from a GP expert and a breast surgeon, both of whom supported a claim against Dr Ferguson. A claim was presented on Mrs Wood's behalf that Dr Ferguson had failed to carry out a proper examination of the left breast in January 2007 thereby missing the lump felt by Mrs Wood. It was Mrs Wood's case that a proper examination would have resulted in the lump being identified and that she should then have been referred under the 2005 NICE guidelines' two week rule. It was alleged that, at the very least, Dr Ferguson should have advised Mrs Wood to return if she continued to feel the lump and then referred her. It was further alleged that Dr Ferguson's failure to make an urgent referral during the July consultation was negligent, as was the failure to document the examination and findings.

Through her defence organisation, Dr Ferguson admitted that the failure to take proper notes and to refer Mrs Wood urgently under the two week rule in July 2007 fell below an acceptable standard of care. However, she disputed the allegations in relation to the January consultation saying that a proper examination was carried out and there was nothing present. Her expert evidence was that the tumour would not have been felt at that stage (which was disputed by Mrs Wood's expert).

Following the issue of court proceedings, the parties entered negotiations and a settlement was reached.

Mrs Wood stated: "I brought this claim because I wanted to highlight the risks of not taking patients seriously and failing to refer for investigations to Dr Ferguson. I was made to feel that I had made a fuss about nothing and therefore did not feel confident in returning to question her findings for a number of months. I would like to stress the importance of carrying out careful and regular examinations and to urge women not to feel intimidated by their GP and to request a referral if they can feel a lump. It is always better to be safe than sorry."

Philippa Luscombe of Penningtons Solicitors LLP, who represented Mrs Wood, said: "Thankfully Mrs Wood was not compromised by the delay in diagnosis but this was only because she went back a second time to ask about her lump. Patients feel nervous about questioning a doctor's findings and therefore it is important that GPs do take patients reporting breast lumps seriously as the implications of dismissing them mean that it can be months or years before a problem is finally identified.

"Patient UK promotes that 'The detection of a lump in the breast causes understandable fear of a cancer diagnosis. Careful and meticulous examination will increase the chance of correct diagnosis. It is important that referrals are appropriate and that information and discussion accompany this assessment'."

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