In May 2008 Larry's GP removed a mole from his right leg. The GP initially thought the mole was benign but after incision felt the lesion "looks more sinister". He excised the lesion. The GP told Larry words to the effect “if you don’t hear from me in two or three weeks you can forget about it”. When Larry did not hear to the contrary he assumed that all was well. In fact it was not. The histology result (which was received by the GP practice, but not acted upon) concluded that the lesion was malignant melanoma. The histology report also stated that Larry should be discussed at a Skin Cancer Multi-Disciplinary Team (MDT) meeting. He was not referred to a specialist by his GP and the test result was not acted upon. The case discussed in a Skin Cancer MDT meeting either at the request of the GP or the laboratory (part of Barts and the London NHS Trust).
In July 2009 Larry noticed a lump in his groin. He underwent a biopsy of his lymph node. The histology report identified metastatic malignant melanoma. The GP made an entry in the notes which confirmed that the original histology report was found in a box in storage indicating that report was received but not scanned electronically or acted upon.
Larry instructed Sam Critchley to investigate. He sadly passed away in January 2011, at the age of 72, from the disease and his son pursued the claim on his behalf. The GP made a personal apology to Larry in his lifetime and his lawyers made a formal admission of breach of duty of care in a letter in June 2013 for "failing to ensure that the adverse pathology result was properly acted upon in 2008"
We obtained expert evidence from a leading oncologist at the Royal Marsden Hospital which said that had Larry been referred to the Skin Cancer MDT in June 2008 as he should have been, he would have undergone wide local excision of the primary melanoma and his condition would have been appropriately managed. He would probably have had a sentinel lymph node biopsy and would have been staged as N1. He would then have undergone right groin lymph node clearance before his disease became advanced and earlier than in fact happened. Had his condition been managed and/or treated as it should have been, Larry would have been cured of his cancer with a likelihood of surviving for at least five years and would have avoided undergoing radiotherapy.
As a consequence of the alleged negligence, Larry suffered the following:
- Unnecessary pain and suffering associated with the symptoms of metastatic melanoma. A PET scan in July 2010 revealed that the cancer had spread to his groin, pelvis, leg, ribcage and right lung. By November 2010 there was a significant visual deterioration and he developed very slow, slurred speech, a feeling of pressure in his head, fatigue and persistent nausea. The cancer spread to his brain and there was subsequently a progressive decline in functions. In addition he continued to suffer from painful, re-occurring skin metastasis on his torso, back, arms, head and face.
- A post-operative seroma in his groin which required daily dressing and draining and severe lymphedema.
- Painful post-operative radiotherapy. His mobility was severely restricted to the extent that he was unable to dress himself
without assistance and he lost all confidence with walking, hardly leaving the house. By December 2010 he had become bedbound.
- Post-operative chemotherapy resulting in severe constipation, painful mouth ulcers and a constant feeling of nausea.
- Death on the 5 January 2011, aged 72.
Sam Critchley issued court proceedings in January 2014 and proceedings were served thereafter. We entered into negotiations to try to resolve the claim and put forward an offer in May 2014. Larry's son accepted the sum of £50,000 and this was made an order of the court on 27 June 2014.
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