Boyes Turner’s medical negligence solicitors have secured an admission of liability for a patient who suffered permanent and distressing injuries as a result of negligent hospital delays in the diagnosis of buccal mucosa cancer (a rare cancer which develops inside the cheek of the mouth). The hospital also made a formal apology to our client. Failure to follow specialist histopathologist’s recommendations for MDT review Our client was referred by his GP to the hospital’s oral and maxillofacial surgery department after he noticed a lump on the inside of his cheek. He was examined in the hospital’s maxillofacial outpatient clinic by a specialty doctor who noted a soft 1.5cm polyp. A biopsy sample taken the same day had atypical features and verrucous carcinoma (cancer) could not be ruled out. A histopathologist’s opinion was sought from a more specialist hospital. Their report arrived five weeks later, advising that precise histological classification of the biopsy sample was difficult, given the atypical features of the possible verrucous carcinoma, and recommending that our client’s histology, clinical and any radiological findings should be reviewed at the hospital’s head and neck multidisciplinary team (MDT) meeting. The recommended review did not take place. Instead, the specialty doctor telephoned our client and told him that the lump was a non-cancerous wart caused by an injury to his inner cheek from a sharp tooth. He was discharged back to the care of his GP and to his dentist to file down the tooth. Delayed diagnosis of buccal mucosa cancer led to extensive surgery and radiotherapy Nearly a year and a half later, our client developed swelling in his gum. He saw a dentist who made a 2-week suspected cancer referral to the hospital. He attended the maxillofacial outpatient clinic and underwent a biopsy the same day, which revealed squamous cell carcinoma. MRI and CT scans subsequently confirmed a large right mandibular tumour extending into the right cheek, tonsil-to-tongue area and floor of the mouth, infiltrating the jawbone and with metastatic spread to the nodes. His case was reviewed at an MDT meeting and he was then referred to a specialist hospital, where he underwent 16-hour surgery to remove the tumour and reconstruct part of the right mandible (jawbone). He underwent adjuvant radiotherapy which, together with the extensive surgery, left him with trismus (tightening of the jaw and inability to open his mouth), numbness and dribbling from being unable to fully close his lips, neuropathic pain, tiredness, weight loss and problems with secretions. His diet was restricted to liquids. He is now at risk of developing significant secondary complications. Admission of liability and apology from hospital We pursued our client’s claim for compensation from the NHS trust responsible for his hospital care for the injuries he suffered as a result of the negligent delay in the diagnosis and treatment of the buccal mucosa cancer. The claim was based on the negligent failure to act on the specialist histopathology report’s recommendation that our client’s histology, clinical and radiological findings should be reviewed at the head and neck MDT meeting. With correct care, following an MDT meeting our client would have had an ultrasound scan, close clinical follow-up and repeat biopsy, which would have led to our client’s squamous cell carcinoma being diagnosed a year and a half sooner. The tumour would have been less advanced at this time, and would have been treated with less extensive surgery, without the need for radiotherapy. The NHS trust have now admitted liability in respect of the delay in diagnosis and accept that with earlier identification a less extensive surgery would have been required and radiotherapy would have been avoided. The NHS trust have made a formal apology to our client. We are now working with our client and our experts to assess the lifelong impact of our client’s injury and value the claim, before meeting with the defendant to negotiate a compensation settlement. If you or a family member have suffered severe injury as a result of medical negligence or have been contacted by HSSIB/MNSI or NHS Resolution you can talk to a solicitor, free and confidentially, for advice about how to respond or make a claim by contacting us.
