15 month delay in diagnosis of anal cancer
Arti Shah was instructed by AB to pursue a claim against the Royal London Hospital in relation to a 14 month delay in diagnosis of squamous cell carcinoma following which she had to undergo chemo-radiotherapy.
AB had undergone an examination under anaesthetic (EUA) and biopsies identified grade 3 anal intra-epithelial neoplasia (AIN), an abnormality of skin cells which are a risk factor for anal cancer. She was referred to the care of the colorectal team at the Royal London Hospital.
Following examination, it was decided she should be kept under surveillance. She had 6 monthly follow up appointments. In early 2011 she was advised that repeat biopsies needed to be performed to exclude any changes to the cells from the previous year. A pre-operative assessment was carried out, but the procedure itself was cancelled.
AB eventually underwent an EUA with biopsies in June 2011 which was negligently performed. A series of 8-12 biopsies should have been taken and sent for histo-pathological examination. If this had been done, it would have identified an extensive area of abnormal cells in the anal canal requiring treatment.
Instead, she remained under review and further investigations were not performed.
By mid-2012, AB had significant concerns. In October 2012 she sought a second opinion from a colorectal surgeon on a private basis. He immediately performed a rectal examination which identified a suspicious lesion. She was referred for an urgent EUA and histology confirmed squamous cell carcinoma. She subsequently underwent 5.5 weeks of chemo-radiotherapy.
We sent a detailed letter of claim after obtaining independent expert evidence from a colorectal surgeon. We alleged that the biopsies taken in June 2011 had been performed negligently. If the correct number had been taken, they would have identified abnormal cells. On the balance of probabilities, treatment in June 2011 would have either prevented the cancer in 2012 or would have led to further biopsies which would have prevented/identified the cancer in 2012. It took a second opinion, which the Claimant obtained on a private basis at her own cost, before she was diagnosed and provided with suitable treatment.
The Defendant admitted that there had been a delay in diagnosis of over 1 year, which had caused AB unnecessary pain and suffering.
Settlement negotiations were entered into, and the case settled before proceedings had to be issued.
At the end of the case, AB's daughter commented:
"I would like to thank you for your support, commitment and professionalism, and for keeping me informed and taking the time to explain the process of the legal proceedings and for a successful completion. I would definitely recommend Arti to family and friends."
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