Human error cited for cancer misdiagnosis

A report into how a woman with breast cancer was mistakenly given the all-clear has concluded that it was caused by human error…

A report into how a woman with breast cancer was mistakenly given the all-clear has concluded that it was caused by human error.

Rebecca O'Malley, 41, from Co Tipperary, had a breast removed in a London clinic in June 2006 more than a year after being told by health professionals in Cork that biopsy lab tests were negative. The mastectomy could have been avoided.

The Health Service Executive (HSE) report concluded that "interpretive human error" was to be blame for the misdiagnosis in March 2005.

"The conclusion comes as a result of an internal re-examination of the original biopsy by two consultant pathologists not involved in the original diagnosis at Cork University Hospital, and an external review by the Mater Misericordiae Hospital which concurred with the internal review, " an HSE spokeswoman said.

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She added that in the light of Ms O'Malley's case, a review of a further 28 separate cases would be carried out as a matter of caution. The report has been sent to the Minister for Health Mary Harney.

Ms Harney has said if the report did not provide answers she will order a full inquiry.

"As a result of this case, Cork University Hospital has put in place procedures, so that in future, in the event of a clinically significant error being identified, an incident form is completed and submitted immediately to the Risk Management Department for expeditious follow up and action," the HSE said.

"Guidelines will be developed between the Laboratory of Histopathology and the Risk Management Department to implement this policy."

The report comes after Ms O'Malley launched a blistering attack on health chiefs for failing to act when the mistake was first noticed, and also for failing to personally apologise for her suffering.

In March 2005, Ms O'Malley underwent fine needle biopsy in Limerick and results from CUH said the sample was benign. The following April she went back to her GP complaining of pains in her breast and a second biopsy in June confirmed she had cancer. Facing a four week wait for surgery Ms O'Malley flew to London for a mastectomy and over the next five months had intensive chemotherapy.

She underwent further surgery on lymph nodes in December 2006 after cancer traces were detected.

Last month as she continued her recovery, the HSE asked her not to go public as CUH was to launch a full inquiry.

Mrs O'Malley said she heard nothing back from the HSE or the hospital for a month. She said persistent calls for an independent review were ignored.

CUH is the second largest centre for breast cancer tests in Ireland and capable of dealing with more than 100 women patients a year. The HSE expressed "sincere regret" tonight for the distress caused to both Ms O'Malley and her family.

Ms Harney announced last night that she had asked the HSE to set up an independent inquiry. She said issues relating to the wider management of Mrs O'Malley's care warranted further evaluation.

PA