Delay in diagnosis and treatment of skin cancer – basal cell carcinoma

This clinical negligence case arose from a delay in diagnosis of skin cancer – basal cell carcinoma. There was a failure to heed the claimant’s reported symptoms of skin lesions and refer the claimant to dermatology for further investigation. Consequently, the claimant suffered over a prolonged period of time before the cancer was diagnosed and treated.

In 2009, the claimant noticed a small, pinkish mark measuring around 1cm near her collar bone. The mark was pink, dry and itchy and would become flaky. The claimant had a second mark on her chest, which would scab and then heal, before scabbing again. The claimant had a third mark on her upper left arm, which appeared as a dry patch. It never improved, but it did not itch, scab or bleed. At that time, these marks did not concern the claimant because they appeared to be blemishes or dry skin. She did not attend the GP.

In 2012, the claimant started to worry about the marks. They had started to change in size and shape. The mark near her collar bone and the mark on her chest had started to follow a pattern of flaking, itching, scabbing over, bleeding, cracking and healing. The process would then start again.

In March 2012, the claimant attended her GP. It was considered that the claimant was suffering from a rash, and she was prescribed cream.

The claimant returned to the GP a few weeks later, as the lesions had been flaring, clearing and then returning for the past three years. The lesions always appeared in the same place. The diagnosis was eczema and the claimant was prescribed cream.

The claimant was reassured that she was suffering from eczema, but the skin lesions did not resolve.

In September 2014, the claimant attended the GP due to weepy patches on her shoulder and upper body. The problem was again recorded as eczema and she was prescribed more cream.

In July 2017, the claimant returned to the GP due to longstanding scabbing lesions. She was prescribed a different cream to treat eczema.

In July 2019, the claimant returned to the GP with a recurrent problem of inflamed patches of skin. She was referred to dermatology.

In February 2020, the claimant was reviewed by dermatology. The lesions were diagnosed as basal cell carcinoma. She subsequently underwent treatment, by way of punch biopsies, excisions and curettage. Some excisions were undertaken by plastic surgeons. The claimant suffered significant scarring as a result of the treatment.

We were contacted by the claimant to investigate a clinical negligence claim. Medical records were requested, and a witness statement obtained from the claimant. The claimant also provided photographs, showing the lesions and their development over the years.

A GP was instructed to report on breach of duty and causation. He confirmed that care had fallen below an acceptable standard by two different GPs in 2014 and 2017.

A dermatologist was then instructed to report on causation. This was supportive, in that with earlier referral, the lesions would have been smaller and the treatment would have been less intrusive. The scarring would have been smaller.

A letter of claim was sent to both defendants, setting out the allegations of negligence.

Due to an upcoming limitation deadline, court proceedings were issued protectively (due to a failure by one of the defendants to respond to our request for an extension).

A response was subsequently received from one of the defendants, denying liability. The other defendant did not respond.

Court proceedings were served on both defendants. Again, a response was not forthcoming from one defendant.

After 11 months from the initial correspondence, the second defendant responded to the claim and denied liability.

Notwithstanding this, settlement negotiations commenced, and a financial settlement was agreed shortly thereafter.

Christina Mallery-Nelson specialises in claims relating to delays in diagnosis. If you would like to ask Christina a question about a potential clinical negligence claim, or if you have a general query about any personal injury claim, contact Christina at Thomson Snell & Passmore solicitors on 01892 701183 in confidence. We offer no win no fee agreements on the vast majority of our clinical negligence and personal injury cases.