Trust Primary Care admits missed diagnosis of Paget's disease | Fieldfisher
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Case Study

Trust Primary Care admits missed diagnosis of Paget's disease

Lindsay Holt secured an admission of liability of behalf of her client, Amy*, following a prolonged delay in diagnosis of Paget's disease.

Amy consulted her GP, an employee of Trust Primary Care Limited, with bleeding and discharge from her nipple. She was referred urgently to Bradford Royal Infirmary under the two-week cancer referral guidelines and, despite presenting at the hospital on two occasions with typical symptoms of Paget's disease, no biopsy was undertaken and no follow up was arranged.

Over the next three years, Amy presented to her GP with typical symptoms of Paget's disease with repeated ulceration, scabbing, and bleeding of the nipple. Despite these repeated attendances, it was not until July 2018 that a non-urgent referral was made for a biopsy of the nipple skin. It was not until November 2018 that Amy was diagnosed with advanced Paget's disease, with virtually complete destruction of the left nipple and metastatic breast disease extending to the regional axillary lymph nodes.

The breast itself had been substantially replaced with malignant tumour, measuring almost 6cm in diameter.  Abnormalities were present in the lymph nodes in the axilla measuring up to 1.3mm.

As a result of the defendants' negligence, Amy has had to undergo a mastectomy, chemotherapy and axillary node removal, all of which would have been avoided with a timely diagnosis. She had intended to extend her family and this opportunity may well now have been lost in light of the debilitating effects of chemotherapy.

The defendants have admitted that it failed to perform a cytology and biopsy of the nipple and that had they done so, this would have led to an earlier diagnosis without the breast tumour having spread to the axillary lymph nodes or through the left breast. They admit that but for their negligence, Amy would have avoided total left mastectomy, axillary node removal and chemotherapy.

The claim now proceeds to valuation.

*name change

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For further information about misdiagnosis claims and GP negligence claims, please call Lindsay Holt on 0330 460 6789 or email


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