Consultant forgot for nearly two years to tell woman about smear audit results, High Court hears
A consultant who did not inform a woman for nearly two years of the audit results of her smear slides which showed they had been incorrectly reported as negative has told the High Court he forgot to do so.
Consultant obstetrician, Dr Matthew Hewitt, said when he met the now terminally-ill Ruth Morrissey (37) in July 2016, soon after getting the information in a letter from CervicalCheck on the audit results, he forgot about the letter filed in the patient’s notes.
“I did not turn back the notes to see the letter to remind me,” he said.
Asked by Ms Morrissey’s counsel Jeremy Maher how he simply forgot, Dr Hewitt said he has hundreds letters coming all the time relating to cancer diagnosis.
“I can’t say I remember every single letter”.
Counsel put it to him that if she had been told about the audit results in 2016, Ms Morrissey would have got a scan and treatment and in all probability, would now be facing life rather than death.
Dr Hewitt disagreed. “I don’t believe the cancer would have been necessarily visible or present," he said.
Earlier, Mr Maher asked Dr Hewitt if he would like to say anything to Ms Morrissey. Dr Hewitt replied: "I completely acknowledge it is awful she has had a recurrence.”
Asked what prompted him to tell Ms Morrissey in May last year of the audit results, Dr Hewitt said there were instructions from the HSE to tell patients immediately.
He said when the first letter came from CervicalCheck in January 2016, there were no clear instructions and he did not feel it necessary to tell patients and it was a screening test not a diagnostic test.
He said he changed his mind later as he became uncomfortable with having the information.
Asked did he accept that Ms Morrissey had raised the possibility of a scan on three occasions, Dr Hewitt said it would not surprise him because patients frequently asked.
He said if he felt it was affecting their patient doctor relationship or the well being of the patient he would do a one off scan, but not for clinical reasons but to reassure the patient.
He said there was no evidence MRI or CT scans were of any benefit in such cases.
This was for a number of reasons. It could give false positive results which could lead to patients having potentially invasive, unnecessary procedures.
He did not think we can ascertain exactly when Ruth Morrissey had the recurrence.
He didn’t believe Ms Morrissey was at a higher risk of recurrence based on the fact that the original tumour was small and the depth was not one to make her high risk.
Scans are not part of a routine follow up, he said.
Asked by HSE Counsel Patrick Hanratty if the manner of his follow up in Ms Morrissey's case departed from international guidelines, Dr Hewitt replied "none whatsoever."
Earlier Ms Morrissey broke down in tears as she told the court how she had put her trust in her consultant to monitor her after she had surgery to remove her first bout of cervical cancer.
She said her consultant should have spotted the recurrence of her cancer which was diagnosed last year but he did not see it for over three years.
She said she trusted Dr Hewitt of Cork University Hospital to give her the required surveillance and she on three occasions had asked for scans, ultrasound or other imaging.
“I put my trust in the consultant to monitor me. He did not see it for three and a half years.”
Ms Morrissey and her husband Paul Morrissey of Kylemore, Schoolhouse Road, Monaleen, Co Limerick have sued the HSE and the US laboratory Quest Diagnostics Ireland and Medlab Pathology Ltd.
It is claimed there was an alleged failure to correctly report and diagnose and there was an alleged misinterpretation of her smear samples taken in 2009 and 2012.
The HSE has admitted it owed a duty of care to Ms Morrissey while the laboratories deny all claims.
The case continues.