Suing the hospital for telling me I had cancer?

[MoralityPondering]

Can I? Should I? Family and friends are telling me to. I was diagnosed 2 months ago at a private hospital after MRI & biopsy. 3 surgeries later and now last week I've been told it isn't cancer at all. They had it looked at 3 times to decide it wasn't cancer so it doesn't seem to be a straight forward decision. I'm not sure it's the right thing to do anyway. I just feel how I did when I was diagnosed - like my life has been ripped apart again.

Although this might seem clear cut it isnt obvious that there is a legal case - yet. Medicine is not an exact science and someone independent may look at this and explain that actually it wasnt obvious that it wasnt cancer and they did the best they could for their patient. Or samples may have been mixed up in a lab and this may be clear cut negligence.

Morality you need a lot more information and sometimes the only way to get that is to start a legal process. The private hospital and the doctor's insurer will be saying dont say too much, you need your notes and an independent review of the data.

I think I'm really struggling to understand how the biopsy could diagnose me with cancer and it not be cancer but also nobody's fault or error. Can anyone have another go at explaining for me? As if I'm a clueless 5 year old preferably.

I managed to speak to a Nurse this afternoon who told me it was a bit like getting a false positive on a pregnancy test. Which you would think would be simple enough for me to get but I still don't.

@MoralityPondering

I think I'm really struggling to understand how the biopsy could diagnose me with cancer and it not be cancer but also nobody's fault or error. Can anyone have another go at explaining for me? As if I'm a clueless 5 year old preferably.

I managed to speak to a Nurse this afternoon who told me it was a bit like getting a false positive on a pregnancy test. Which you would think would be simple enough for me to get but I still don't.

Start a complaint.

Claim for damages, whatever they are

Ok so if you had HER2, it has a much higher false positive rate, but that’s why they’re so careful to test and retest.

The reason I find it very unlikely that there’s no human error in your case is because you were told you were ER/PR positive. The chance of a false positive for ER is only 6.8%. The chance of a false positive for PR is only 10.3%. I’m shite at maths but I’m sure someone will come along that can tell you exactly how small the chance is of having both those false positives together. Yes, of course it’s possible, but with rates like that, I would definitely be talking to a solicitor. Maybe in the eyes of the law, this will turn out to be “no one’s fault” but in the eyes of common sense, they need to come the fuck on (especially the full node clearance! Wtf!).

Also, @MoralityPondering, I’m not sure if they warned you of this, but please be very careful with your arm on the side that had the full node clearance. My mother is extremely slow to heal any injury on the arm “without” lymph nodes (she had a mastectomy), and it seems (I haven’t done research) to scar more easily.

@RightYesButNo

Ok so if you had HER2, it has a much higher false positive rate, but that’s why they’re so careful to test and retest.

The reason I find it very unlikely that there’s no human error in your case is because you were told you were ER/PR positive. The chance of a false positive for ER is only 6.8%. The chance of a false positive for PR is only 10.3%. I’m shite at maths but I’m sure someone will come along that can tell you exactly how small the chance is of having both those false positives together. Yes, of course it’s possible, but with rates like that, I would definitely be talking to a solicitor. Maybe in the eyes of the law, this will turn out to be “no one’s fault” but in the eyes of common sense, they need to come the fuck on (especially the full node clearance! Wtf!).

Thank you. Definitely HER2 negative. And surely they look at the cells from the biopsy and how they are behaving etc.

@RightYesButNo

Ok so if you had HER2, it has a much higher false positive rate, but that’s why they’re so careful to test and retest.

The reason I find it very unlikely that there’s no human error in your case is because you were told you were ER/PR positive. The chance of a false positive for ER is only 6.8%. The chance of a false positive for PR is only 10.3%. I’m shite at maths but I’m sure someone will come along that can tell you exactly how small the chance is of having both those false positives together. Yes, of course it’s possible, but with rates like that, I would definitely be talking to a solicitor. Maybe in the eyes of the law, this will turn out to be “no one’s fault” but in the eyes of common sense, they need to come the fuck on (especially the full node clearance! Wtf!).

When I googled it (so no expert knowledge here at all!!) every result I got said that most fibroadenomas have progesterone receptors and some have oestrogen receptors, so that might explain it?

@RightYesButNo

Ok so if you had HER2, it has a much higher false positive rate, but that’s why they’re so careful to test and retest.

The reason I find it very unlikely that there’s no human error in your case is because you were told you were ER/PR positive. The chance of a false positive for ER is only 6.8%. The chance of a false positive for PR is only 10.3%. I’m shite at maths but I’m sure someone will come along that can tell you exactly how small the chance is of having both those false positives together. Yes, of course it’s possible, but with rates like that, I would definitely be talking to a solicitor. Maybe in the eyes of the law, this will turn out to be “no one’s fault” but in the eyes of common sense, they need to come the fuck on (especially the full node clearance! Wtf!).

So I have no idea about the science of this at all, but based on the maths, those are actually pretty high false positivity rates. To estimate the likelihood of having both together , I believe you just multiple the probabilities so 0.068x0.103=0.007 (someone please correct me if I’m wrong!!) So this would be a probability of 0.7%. So that would be about 1 in every 140 people tested would get a false positive on both. So not altogether that rare.. As I say I have zero knowledge of this area of medicine though so could be talking complete rubbish..

OP I am so so so sorry for what you have been through. I can’t even imagine . Wishing you all the best for finding a healing way forward.

*this assumes that the false positive probability rates for each are independent of each other..

I’m so sorry you’ve been through any of this- I did have breast cancer and had node clearance and associated cording- as well as lymphoedema- I still have pain and swelling nearly 6 years on- you need a thorough explanation- I had a sentinel lymph node biopsy to confirm cancer had spread to the armpit and when it was found then had node clearance- so did you have a sentinel node biopsy and this was what confirmed that you didn’t have cancer ?
These are life changing ops that needn’t have happened- and anyone who says just be grateful it wasn’t have no idea-and I’m talking now as someone who has a different cancer recently diagnosed

The mother of my child's schoolfriend had the same happen to her. It was reported in the press that she was paid close to £350k in compensation. I am so sorry that this happened to you too. I think you are owed answers at the very least.

The test of whether there was a breach of duty is not whether there was an error, errors happen in medicine (as do side effects, complications etc), it is whether a reasonably competent clinician would have made the error. So expert opinion would be needed on that. It is possible that an error is made and there is no negligence, even if there has been damage caused. But the only way to know if you have a case is by your solicitor instructing an expert to assess this.

You need an expert to look at your notes and the various reports and say if there was negligence. The reason 2 people can look at a biopsy and not get the same result is that there would have been changes in the cells from cancer or your actual condition but whether those changes definitely mean cancer or not is always as clear as you might think. This is a study about people looking at biopsies and thinking different things. www.breastcancer.org/research-news/study-on-accuracy-of-biopsy-results

Maybe think of it as looking at very slightly different shades of the same colour - everyone can see the difference between black and white but what shade of grey is actually benign and what shade is cancer? And if it's light grey now is it likely to be getting darker?

Another expert will be able to tell you if this was someone looking at the wrong shade card, someone so confident it was dark grey that they didnt seek a second opinion when someone else might have said light grey or actually it was on the border between light and dark and the risk of being wrong could have killed you.

No-one here is able to look at the shade card. No-one here can tell you whether there was consultation between experts before the op or not. You need someone who can tell you that, you need an independent review of the evidence.

@alreadytaken

You need an expert to look at your notes and the various reports and say if there was negligence. The reason 2 people can look at a biopsy and not get the same result is that there would have been changes in the cells from cancer or your actual condition but whether those changes definitely mean cancer or not is always as clear as you might think. This is a study about people looking at biopsies and thinking different things. www.breastcancer.org/research-news/study-on-accuracy-of-biopsy-results

Maybe think of it as looking at very slightly different shades of the same colour - everyone can see the difference between black and white but what shade of grey is actually benign and what shade is cancer? And if it's light grey now is it likely to be getting darker?

Another expert will be able to tell you if this was someone looking at the wrong shade card, someone so confident it was dark grey that they didnt seek a second opinion when someone else might have said light grey or actually it was on the border between light and dark and the risk of being wrong could have killed you.

No-one here is able to look at the shade card. No-one here can tell you whether there was consultation between experts before the op or not. You need someone who can tell you that, you need an independent review of the evidence.

👌🏻👌🏻👌🏻 Excellent post and advice.

@alreadytaken that is exactly right. A good PI solicitor who specialises in clin neg will be able to find you the appropriate expert to advise.

@alreadytaken

You need an expert to look at your notes and the various reports and say if there was negligence. The reason 2 people can look at a biopsy and not get the same result is that there would have been changes in the cells from cancer or your actual condition but whether those changes definitely mean cancer or not is always as clear as you might think. This is a study about people looking at biopsies and thinking different things. www.breastcancer.org/research-news/study-on-accuracy-of-biopsy-results

Maybe think of it as looking at very slightly different shades of the same colour - everyone can see the difference between black and white but what shade of grey is actually benign and what shade is cancer? And if it's light grey now is it likely to be getting darker?

Another expert will be able to tell you if this was someone looking at the wrong shade card, someone so confident it was dark grey that they didnt seek a second opinion when someone else might have said light grey or actually it was on the border between light and dark and the risk of being wrong could have killed you.

No-one here is able to look at the shade card. No-one here can tell you whether there was consultation between experts before the op or not. You need someone who can tell you that, you need an independent review of the evidence.

Thank you this is a really great explanation. I'm not looking at this stage to "find" negligence in terms of a legal case. I just want to understand the science of how it could have happened

Glad it helps. The positive bit was bothering me so I had a quick google and came across this
www.ncbi.nlm.nih.gov/pmc/articles/PMC1731078/

I'm going to highlight this bit for you

"Thus, the nature and degree of dysregulation of ER in benign breast lesions is broadly in accordance with the degree of risk of developing breast cancer with which they are associated."

If I read it right it's saying you can also get positive results in benign growths and that is more common in the benign growths that have increased risk of developing into cancer later. So if this was not a mix up and your results were positive then that might have indicated a slightly higher risk of breast cancer later. However breast cancer in such growths is very rare wjso.biomedcentral.com/articles/10.1186/1477-7819-12-335 so it seems likely that there would have been watchful waiting or at worst removal of the growth. You should have been given information and a choice of treatment.

Understanding how this sort of thing can happen doesnt necessarily mean that it should have happened. As an example did those involved place too much weight on the growth being positive in interpreting the biopsy? There is scope for this to have been negligence, there is a possibility that there was no negligence.

I dont like that you havent been given a full explanation.

I’m so sorry this happened to you. On test results being open to interpretation doesn’t that then become what a patient was told? Meaning ‘we don’t know 100% that this is cancer but based on x, y and z we’d recommend this treatment. That would be different to ‘you have cancer and need this treatment’?

In the case I was working on yesterday the test results showed it was likeliest to be cancer but there was an alternative diagnosis of a rare but much more benign condition. The doctor just told the patient he had terminal cancer and did not mention the other diagnosis. The case is that, had been told there was another potential diagnosis he would not have suffered as severe mental health issues as he did, in the months before they determined that he actually had the rare condition and not cancer. I don't know if the claim will succeed but that is what they are running.

The NHS has screwed me over several times. I too have had avoidable sugeries.

I haven’t sued them because any money I won would come out of the NHS budget and it is better spent there than on a new tv for me or whatever.

If I was destitute I might though. So guess it depends on your situation.

@Skysblue

The NHS has screwed me over several times. I too have had avoidable sugeries.

I haven’t sued them because any money I won would come out of the NHS budget and it is better spent there than on a new tv for me or whatever.

If I was destitute I might though. So guess it depends on your situation.

It wasn't the NHS. And are you sure the nhs use it's normal funds for litigation? No insurers involved?

No the money does not "come out of the NHS budget". It is met by their insurers. Premiums are paid regardless.

@Skysblue

The NHS has screwed me over several times. I too have had avoidable sugeries.

I haven’t sued them because any money I won would come out of the NHS budget and it is better spent there than on a new tv for me or whatever.

If I was destitute I might though. So guess it depends on your situation.

The money is not for a new tv... It is awarded to cover consequences such as loss of earnings, loss of partner’s earnings, care costs etc. There is also a high bar set with proof of negligence and proof of losses that can be shown to be directly attributable to negligent care. All these posters who could have sued but didn’t seem to have a mistaken idea of the process. It’s also quite insulting in the context of this thread.

Again, NHS Trusts are insured (through NHS Resolution), they pay their premiums whatever, and the costs of litigation are met by the insurance company not the Trust.

When I googled it (so no expert knowledge here at all!!) every result I got said that most fibroadenomas have progesterone receptors and some have oestrogen receptors, so that might explain it?
The breast itself has estrogen and progesterone receptors. The question is: how many. For example, with ERs, normal non-cancer amount in normal breast tissue was 0-37 with a mean of 4. For women with breast cancer, it ranged from 0-139 with a mean of 37. It seems like OP’s surgeons should have known the range they were looking for that means “cancer without a doubt” or communicated to OP if there was a grey area. I’m not sure either on that.
cancerres.aacrjournals.org/content/canres/51/7/1817.full.pdf

So this would be a probability of 0.7%. So that would be about 1 in every 140 people tested would get a false positive on both. So not altogether that rare..
I had to go through the biopsy process with a complex divided ovarian cyst. Quality assurance meant running more than one slide or section or whatever it was exactly, so in my case at least, it would have been 3x that number (0.7%). I hope they didn’t just run one slide on her biopsy and call it a day, which is why I thought the percentages would be getting down to something like .7%^3 (so something like 0.00003%). I could be completely wrong on that, though. I realize everywhere has different quality assurance; you’re completely right. Hopefully being able to get her complete medical records will show OP this.