GP sued over alleged negligence says patient declined breast exam
A GP accused of not correctly examining a 32-year-old woman, who later developed terminal breast cancer, has told the High Court she could not feel a lump when she examined the patient’s under arm.
And Dr Norma Donlon insisted that after the underarm exam, Christine Rossiter had refused a request that she carry out a breast examination – disputing her patient’s claim that she had gone to the doctor specifically for a breast check-up.
Ms Rossiter, a graphic designer, has sued her GP, claiming that if the cancer had been correctly detected when Ms Rossiter first found the lump in 2014, she could have expected to fight the disease and live on into her 70s.
Now aged 36, the mother-of-two has been given just months to live. Ms Rossiter told the High Court last month that her GP had dismissed her concerns about a lump under her arm – and allegedly told her she was too young to have cancer. Dr Donlon was the first witness for the defence.
She told Judge Anthony Barr she saw Ms Rossiter for a consultation at the Hilltop Surgery in Dublin’s Raheny in September 2014. Looking at her notes, she recalled: ‘She informed me that she was concerned by a lump under her arm.’ Dr Donlon said she discussed it with her patient, and recorded that the lump had been there for three months, was not tender, and that Ms Rossiter did not have a family history of breast cancer.
She said she then palpated the area around Ms Rossiter’s left armpit, and her right. ‘I didn’t find anything,’ she confirmed. She said she tried a second time, and still could not find a lump.
But she said she still thought a breast examination was necessary, and she said she had ‘no doubt’ that she suggested this to Ms Rossiter, of Ceanchor Road, Howth, Co. Dublin.
‘I don’t know her exact words, but I do recall that it was declined,’ the doctor said.
‘The reason I can say that, is that it seemed unusual to me.’ Dr Donlon said she did not push the issue, as she said she weighed up all the factors, including the lack of a lump.
She said she believed a lump could have been caused by a lymph node being inflamed by Ms Rossiter’s eczema.
She said that any reassurance given to Ms Rossiter would have been limited to this. ‘I would never have given any broad reassurance that all was well with the world.’ Dr Donlon said she would have advised Ms Rossiter to return if the lump came back.
Ms Rossiter’s counsel John Gordon SC, said: ‘Is there any reason in the wide world why she would have refused the most obvious examination?… I am putting to you that it did not happen.’ Dr Donlon said she could not explain it. Ms Rossiter has told the court that she left the practice feeling relieved, but that the lump never went away. In August 2016, she went to another doctor, who made an urgent referral to the Beaumont Hospital breast clinic.
A cancerous tumour was found in her left breast. It was diagnosed as stage 2, which was significant but not immediately life-threatening, the court has heard. But by the next month, scans showed it had spread to her bones and lymph nodes, and she was diagnosed with terminal, stage 4 cancer. It has since spread to her brain, and she is undergoing palliative care and treatment.
Mr Gordon has said that in September 2016, the tumour in her breast measured five centimetres. He said the plaintiff’s experts would say that in 2014, it would have been just 1cm-1.5cm long. It is alleged that an experienced doctor should have found a lump in her breast, and referred it on for investigation.
The case continues.
Financial Blueprint of a Medical Negligence Case
Medical Negligence and personal injury cases are often a topic of conversation in Ireland. A case is built on the strength of expert reports and testimony. The ancillary costs are driven up by lack of access to salient medical records and details. This further underlines the need for mandatory disclosure and the need for patients to have live access to their own updated medical records.
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