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Alison McCormack. RTÉ Investigates

Woman had to have aggressive chemotherapy and radiation treatment after cancer misdiagnosis

RTÉ Investigates has confirmed that two patients had their cancer misdiagnosed at the hospital.

A HOSPITAL PATHOLOGIST working at St James’ Hospital misdiagnosed two cancer cases, a new investigation reveals.

RTÉ Investigates has confirmed that two patients had their cancer misdiagnosed at the hospital.

One of the patients - Alison McCormack – discovered a lump on her right breast in 2010.

After a series of tests at St James’s Hospital she was diagnosed with DCIS (Ductal Carcinoma in Situ), a localised form of breast cancer, in 2010.

This was seen as a fortunate diagnosis as it is technically precancerous (Stage 0).

“So my surgeon had explained you’re lucky to have DCIS, as in it’s a cancer that is curable by surgery,” Alison said.

She went on to have a mastectomy and breast reconstruction but because her cancer was diagnosed as non-invasive, it was decided that further treatment such as chemotherapy wasn’t needed.

Two years later in October 2012, Alison discovered a lump on her neck and was again referred to St James’s for tests.

“I saw my own consultant and she said that they’d looked at the biopsy and it was the original breast cancer that was back, it was the DCIS and it had now spread into the lymph nodes of my armpit and up to my neck,” Alison said.

So we were shocked and we couldn’t, we couldn’t understand it and actually she couldn’t understand it either. She basically said it’s very rare for DCIS to come back.

Discovery 

Alison began a year-long treatment plan including an aggressive 6 month course of chemotherapy.

She had all the lymph nodes in her right arm removed and had five and a half weeks of radiation. The treatment has left her with lifelong health issues including lymphedema which results in severe swelling of her right arm.

She kept wondering why her cancer had come back. In late 2013, she began to ask questions and at her request a meeting with St James’s Hospital was arranged.

Alison was informed then that the cancer had been misdiagnosed  – almost a full year after she re-presented at the hospital with cancer in her neck.

After a receiving a report of the misdiagnosis, Alison found out that the hospital had been aware of it since February 2013 but she had not been informed.

“Had Alison not pursued the questioning that she was determined to find out about, there is absolutely no way she would ever have learned that were was a mistake on the part of this hospital,” said Rachael Liston, Alison’s solicitor.

The report confirms that originally the lump on her neck was reported as showing DCIS only. However, after doctors reviewed the original slides they discovered that invasive cancer had been missed by the pathologist.

The report concluded that the error was one that could have been made by any pathologist and did not represent incompetence.

Review

To support this finding, St James’s decided to review a portion of the doctor in questions’s caseload.

In all the doctor had analysed over 300 breast cases in 2010 – the year of Alison’s misdiagnosis. The review looked at every 10th case, as well as a further nine DCIS cases – that is cases with a precancerous diagnosis similar to Alison’s.

So of the 39 cases reviewed, two were found to have been misdiagnosed. It is not clear if the second person has been informed of the misdiagnosis.

Both cases came from the DCIS category only, meaning the pathologist had misdiagnosed 2 out of nine cases – an error rating in excess of accepted international pathology norms.

Professor Ian Ellis, a leading consultant pathologist based at Nottingham City Hospital, reviewed Alison’s case.

“It sounds very small, two out of 39 but these are very, very fundamental and serious errors so they are red flag type of errors,” Ellis concluded.

And so in my opinion that is of concern. The number of breast cases that he had looked at were a few hundred, that’s not a huge number of cases and certainly if I was asked my opinion on what to do I would recommend a review of all the cases.

St James’s Hospital decided a full review of all breast cases examined by the pathologist was not required.

In a statement to RTÉ Investigates, St James’s said it was aware in February 2013, there had been a breast cancer misdiagnosis in the case of Alison McCormack, however the hospital did not inform her of the misdiagnosis for a further 9 months.

It said it “treated the review of her case, which was completed in February 2013 as part of the overall review and shared it with the patient together with other related documents in November 2013 when the review was complete”.

The hospital also said it “fully acknowledges that the missed diagnosis error occurred. For this the hospital was and remains unequivocally sorry.”

Despite repeated requests from RTE Investigates, St James hospital failed to confirm that the second patient has been informed that she was misdiagnosed.

You can watch an account of the full investigation tonight on RTÉ Prime Time 

Read: Tallaght Hospital says new app will ‘help patients get the most from their treatment’

Read: ‘This should not have happened’: Parents of baby who died shortly after birth settle case with hospital

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    Mute Waters Edge
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    Feb 20th 2018, 9:00 PM

    A family member had cancer. It had spread upon diagnosis. Later, they thought it had spread to the bones. An MRI was performed – result – over 90% positive for cancer. A bone scan was also performed that week, results came back CLEAR for cancer. They decided to do a biopsy. Results came back ClEAR, no cancer, it was a bone cyst. They said they had taken 5 or 6 samples in and around the area and it was definitely not cancer. Three months later, a pet scan was done, it WAS cancer all along. They have since passed away. If I was diagnosed with cancer, I would have absolutely no confidence if they sent me for scans and it came back clear, I wouldn’t believe them.

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    Mute Vigo the Carpathian
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    Feb 20th 2018, 9:24 PM

    @Waters Edge: I’m in a similar situation myself with my father right now… One of the problems is that there’s a culture of never admitting they’re wrong.. and god help you if you try to go to someone else for clarity on something and they find out because apparently you’re “disrespecting them” in some way. Oh that and their unwillingness to engage if something else serious pops up in a different part of the body which usually happens with cancer.. apparently “that’s not their department”… “better go to you’re GP for a referral” or “take them to A&E if they get bad” ..Jesus wept but what’s the point of them saving a guy only for him to die a few weeks later on a trolley…

    51
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    Mute Waters Edge
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    Feb 20th 2018, 9:37 PM

    @Vigo the Carpathian: I questioned them numerous times on the results. How can it happen? I mean a bone scan shows up hotspots for cancer and a biopsy it supposed to be bullet proof when it comes to diagnosing cancer. Who slipped up reading these results or are they even properly trained? It is terrifying to think that this is happening and it seems to constantly in the news lately. They never could give me an answer, all I got was, well, these people are highly trained. My mam had metastatic cancer upon diagnosis but she had been responding well to treatment. They took their eye off the ball and although we know the cancer would have taken her in the end, we have to live everyday devastated and completely broken hearted, wondering how much longer we could have gotten with her or if she would still be here.

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    Mute Waters Edge
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    Feb 20th 2018, 9:47 PM

    @Vigo the Carpathian, I meant to add that I am sorry for what you are going through. The worry, the stress, the constant fear, the nausea you feel daily as you look on helpless. I always remember going in to get scan results from the consultant with my mam and just wanting to cover her ears so she wouldn’t hear the life devastating news they were about to tell her. I just wanted to protect her and think I could have handled it more if it was happening to me and not her. It is not an easy journey to have to travel. I wish you and your dad all the best. Question everything and shout as loud as you can to be heard.

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    Mute Vigo the Carpathian
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    Feb 20th 2018, 10:33 PM

    @Waters Edge: Sorry about your mam by the way.. Funny…we called our mother the same… and still do.. None of this new age “mom” or “mummy” crap… Just kind of brought her memory back for a second…

    12
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    Mute cormac o neill
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    Feb 20th 2018, 8:22 PM

    And all that bothers TDS at the moment along with Leo is to bring in Abortion on demand

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    Mute Malachi
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    Feb 20th 2018, 8:43 PM

    @cormac o neill: >insert tiresome abortion talking point on an unrelated story here

    God, do ye ever get bored? Seriously.

    145
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    Mute cormac o neill
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    Feb 20th 2018, 8:47 PM

    @Malachi: well no it’s not.. it shows why our politicians need to divert their attention to more pressing issues

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    Mute The Debater
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    Feb 20th 2018, 10:37 PM

    @cormac o neill: what has a politician got to do with this issue? some people think TD’s can save the world, its the medical people we really lie on and they failed in this instance

    24
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    Mute @TJPPK
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    Feb 20th 2018, 8:29 PM

    Every week there seems to be a story like this of HSE misdiagnosis. Can we really trust them to be 100% correct all the time with the unborn
    #Savethe8th

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    Mute Dave O Keeffe
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    Feb 20th 2018, 8:34 PM

    @@TJPPK: you’re right, let’s ignore the experts.

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    Mute cormac o neill
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    Feb 20th 2018, 8:38 PM

    @Dave O Keeffe: what experts

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    Mute Vigo the Carpathian
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    Feb 20th 2018, 8:49 PM

    @@TJPPK: You know what.. you’re absolutely right.. HSE can’t be trusted..not enough experience in the field anyway ..Better bring in private outside help.. How does Marie Stopes or CASA sound to you ?

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    Mute cormac o neill
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    Feb 20th 2018, 9:18 PM
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    Mute John003
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    Feb 20th 2018, 8:39 PM

    Problem with the HSE seems to be a shortage of consultants….Thoes that are there are overworked and can make mistakes……They have lots of managers and even nurses but few medical consultants….

    61
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    Mute cormac o neill
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    Feb 20th 2018, 8:23 PM

    Harris is not fit to be Health Minister… His voice wrecks my head

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    Mute David Sinclair
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    Feb 20th 2018, 10:19 PM

    @cormac o neill:
    He’s a spoofer. Fine Gael is full of them.

    24
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    Mute Karl
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    Feb 20th 2018, 10:12 PM

    Last time I checked, no one person was perfect and every doctor will recommend a second opinion

    Im not having a go at this women, its terrible to go through all this over a mistake BUT it was an honest mistake and we all make them even the most qualified and experienced of us

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    Mute cormac o neill
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    Feb 20th 2018, 8:40 PM
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    Mute Tony Dowling
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    Feb 20th 2018, 10:29 PM

    Privatise privatise privatise. Jesus christ we are idiots entrusting our health service to the private sector.

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    Mute Tony Dowling
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    Feb 20th 2018, 10:31 PM

    @Tony Dowling: public sector should read

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    Mute Vigo the Carpathian
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    Feb 20th 2018, 10:53 PM

    @Tony Dowling: We don’t have the population that could support a fully privatised system. Insurance rates would have to be astronomical to cover healthcare costs AND generate a profit …couple that with things like astronomical rent/house prices and car insurance and we’d all be living in poverty…more so than we do now.. We’re not talking about everyone getting VHI for a few hundred quid a year here. You’d be looking at hundreds of Euro a month if not thousands….and let’s face it.. in this country we’d be bent over a table for a profit..

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    Mute Elizabeth Gregory
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    Feb 21st 2018, 12:37 AM

    @Vigo the Carpathian: ….and that Vigo the Carpathian is ‘exactly’ and ‘precisely’ what Leo and his merry band want. They and their current coalition partners are the most despicable government this country has ever suffered. They worship at the alter of Profit. Profit at any expense. If you’re not fit and financially strong enough to swim with the piranhas, you get annihilated. It’s all about the economy stupid! Society takes a very weak and unimportant back seat.

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