A High Court ruling has found no medical negligence in the case of a woman who sued the HSE for an alleged delay in her breast cancer diagnosis.
Ms Catriona Crumlish (41) of St Finian’s Park, Moville, Co Donegal, sought damages for injuries she alleged were caused by doctors at Letterkenny University Hospital failing to diagnose her breast cancer in May 2017.
Ms Justice Mary Rose Gearty ruled that Ms Crumlish’s evidence failed to establish that she had a 15mm cancer in May 2017, which she claimed was not detected until October.
Ms Crumlish’s evidence was based on an academic paper which analysed the growth rate of breast tumours. The data presented in that paper was strongly contested by the HSE. The plaintiff submitted that if her cancer was diagnosed earlier, she would not have had nodal removal surgery and would not have suffered related adverse effects. Following chemotherapy, radiotherapy and a double mastectomy, Ms Crumlish is now cancer-free.
The judge ruled that Ms Crumlish’s cancerous tumour “probably was present in May” but was “probably undetectable at that point”. She was originally referred to the Letterkenny breast clinic by her GP who felt two hard lumps on her right breast – one comparable in size to a pea, the other to a peppercorn.
Ms Crumlish was examined at the hospital in May 2017 by breast surgeon Mr Michael Sugrue, who noted a 15mm pea-sized lump and could not palpate the smaller, peppercorn-sized lump. He then referred the patient to radiology, where Dr Conal Mac a Bhaird reported: “multiple small cysts up to 12mm”. Mr Sugrue reassured the patient that she had cysts and, while they might change size, she should not worry.
Ms Crumlish returned to LUH on 9th October 2017 following the discovery of two more lumps. On Thursday 12th October 2017, Mr. Sugrue confirmed that the Plaintiff had HER2-positive breast cancer.
The judge ruled that many of the systems used by Mr Sugrue are exemplary. The evidence also established that if the lump detected in May was 15mm, it would probably have been obvious to the radiologist as it looked nothing like a cyst.
The judge dismissed the suggestion, based on the peer data on ‘doubling time’ of tumours, that the plaintiff’s cancer would have been detectable in May. Ms Justice Gearty said the academic paper had limitations and may be misleading, as cancers grow at different rates. It was found that the patient’s damage was probably caused by an interval cancer, i.e. a cancer detected/presenting within 12 months after a mammographic screening.
Although the Plantiff was ordered to pay the costs of the action, a stay on the costs order has been put in place to allow Ms Crumlish to appeal against the High Court decision. She has 28 days to do this.