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GP Denial Of Cancer Symptom Visit Dismissed On Appeal

Patient in hospital bed
16th June 2015

A GPs defence claim that a delay in diagnosing a female patient’s breast cancer lump was because the consultation had not taken place was dismissed at a Court of Appeal.

Over a period of nine months, the defendant, aged 43, visited her GP on a series of occasions with complaints over her monthly cycles, for which appropriate treatment and medication were prescribed.

It was during one of the visits, the defendant alleges, that she informed her GP of a lump in her left breast, which she further claims was wrongly diagnosed as a blocked milk duct. A diagnosis of  breast cancer was delayed for nine months - due to the GP insisting that the condition was hormonal -  until a second opinion was sought, by which time, the cancer had spread. A mastectomy (breast removal) and four months of chemotherapy were needed to be carried out and a five year course of hormone therapy also begun.

The GP denied any consultation took place where the patient complained of a lump in her left breast. The defendant argued  that there were no notes of the particular consultation, and if a lump had been identified, the patient would have been referred to a breast clinic.

Judge ‘preferred’ patients’ evidence

The judge at the initial hearing found in favour of the patient’s evidence, to which the defendant appealed on the grounds that the “findings of the facts were inconsistent” and the judge had also “failed to provide reasons” for rejecting the defendant GP’s evidence.

The Appeal Court held that the judge’s findings were not inconsistent. The Judge was only required to set out his line of reasoning for his findings of fact based on the evidence (which he had done) and was under no obligation to set out the reasons for rejecting the Defendant GP’s case.

In a case where facts are in dispute between the parties, a Judge is only required to show that a finding of fact has been made on a “reasoned” basis. The party whose evidence is “not preferred” is not entitled to appeal on the basis that they have not been provided with reasons why their evidence has been rejected.