When Caroline was pregnant with her first child, she noticed a lump in her right breast, which she reported to the midwife. She was reassured and while in the hospital delivering her baby, she again reported the breast lump to staff, who documented the lump, that it was tender on examination and assisted her with breast-feeding by giving her a nipple shield for the affected breast, advising Caroline she had an inverted nipple.
In view of her symptoms, she was referred to the breast clinic for further management and some 12 days after her discharge from the delivery ward, she was seen by a specialist oncoplastic breast clinician in the breast clinic.
The breast surgeon briefly examined Caroline's breasts and suggested she had a blocked milk duct but could feel no distinct lump. No comment was made about the appearance of the inverted nipple, no ultrasound or mammogram was undertaken or suggested and Caroline was discharged without arrangements for follow up
Caroline continued to breastfeed her daughter and used a breast pump for a little while longer. She was struggling to feed from right breast and she was concerned about ongoing inversion and discomfort but was reassured by the outcome of the breast care clinic appointment.
Seven months later, Caroline was diagnosed with Grade 3 invasive ductal carcinoma of the breast (breast cancer) HER receptor positive, with metastatic disease. Her long-term prognosis has been adversely affected by the delay in diagnosis. She has been unable to return to work and her ability to care for her daughter and partner, who lives with a brain injury, have been seriously affected.
Following service of a formal Letter of Claim, the defendant Trust has apologised to Caroline, offering an admission of liability and agreeing to make interim payment.
The matter now proceeds to valuation.
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