The Mater Misericordiae University Hospital has settled out of court a legal action taken by a terminally ill woman who claimed her cancer diagnosis was delayed for more than a year because vital blood tests were allegedly not followed up.
Mary O'Connor's legal action against the Dublin hospital was expedited in the High Court because of fears that she could die before her case could be heard.
An expert report alleged that the hospital had "failed to act" on blood test results that showed elevated levels of serum that may have led to an earlier diagnosis.
The Mater Hospital has denied the allegations. It agreed last week to pay Mary O'Connor an undisclosed sum plus her legal costs in settlement of the action, without admission of liability. The hospital declined to comment on the case this weekend.
Mary O'Connor, who has "tumours from head to toe", told the Sunday Independent that she was relieved with the settlement and urged patients to "keep asking questions" and to never assume, as she did, that no news was good news.
In her home in Lusk, north county Dublin, the day after the settlement, Mary O'Connor pulls off her wig to reveal baby tufts of fair hair. Although her cancer is terminal and she has been on continuous chemotherapy for a year and a half, she still hopes her hair will grow back.
"Do you mind if I take it off," she asks, slapping her wig on the counter. She explains that it sometimes irritates the tumours in her skull, such as on the hour-long drive into the Four Courts last Wednesday, "but it's not something you can take off in the middle of the traffic."
She is speaking out to urge others "not to do what she did", which was to not chase things up, and as a result it was a year before she was aware that the cancer she thought she was clear of had returned.
Mary (57) was first diagnosed with breast cancer in 2007. She was 49 and life up to then was good. She worked in credit control for what was then Eircom, with "a great team" and lived a full life with her husband, Des, and her then teenage son. She had a mastectomy, chemotherapy and radiotherapy. Her treatment was successful, her scans were clear and she returned to work.
In 2012, she noticed pain in her arm and shoulder, that became worse over time. By then her course of treatment for breast cancer had finished, but her condition was monitored with regular follow-up visits to the hospital.
Despite the bone pain she complained of, her scans were clear.
"Friends of mine were convinced it was rheumatoid arthritis, one of them had it and she had been treated by a really good doctor," she said.
In June 2015, she attended a rheumatologist, who sent Mary for an MRI scan. Two days later, she got an urgent phone call summoning her to hospital. The prognosis came a week later, while she was still in hospital. She was alone at the time, and felt like "a frightened child".
"They said you have advanced stage four cancer. There is nothing we can do but we can contain the tumours," she says.
She was told the only area of her body that was clear of cancer was her right arm, ironically the source of her initial pain. When she asked how long she had to live, she was told that women of her age with her type of cancer, normally live one to five years.
The fact that her illness was terminal hit her straight away. But she did not allow herself the luxury of dwelling on it. She had her husband to think about. With cruel timing, Mary's husband, Des, had been diagnosed with lung cancer in January of that same year.
"I was on my own. I had to be strong. Des was sick. He only just had an operation. A couple of months previously he was really, really ill. I wanted to cry but I didn't, because you have to get on with it."
Mary was immediately put on a care plan, that involved chemotherapy and outreach care from her local hospice. The nursing and oncology staff at the Mater hospital have been "wonderful", she says, while the staff at St Francis Hospice in Raheny have helped her live with her illness.
It was the system that let her down, she says.
Mary didn't realise this until she applied for her medical file last year, with the help of her solicitor, Dermot McNamara. Only then, did she learn that blood tests carried out in May 2014 - a year before her diagnosis - suggested that all was not well.
Tests for a tumour marker known as CA 15-3 returned an elevated result that was above normal levels. She returned for a review a week after the blood tests, complaining of pain, but there was no evidence of any investigation being requested or carried out, according to the report, according to an expert report prepared for her case.
Mary says she was never told about the blood test results, and there were no records on file to indicate they had been sent to her GP.
The report concluded that if the blood test results were an indication that her cancer had returned, she could have been diagnosed around one year earlier. While that may not have boosted her chances of survival, the report found that her quality of life would most likely have been improved.
Mary alleged in her case against the hospital that she was "deprived of the benefit of early diagnosis and treatment".
The Mater Hospital denied the allegations, including the significance of Mary's blood results, that she was denied an early diagnosis, or that she suffered any personal injury. The hospital acknowledged that her cancer was terminal but denied any negligence or breach of duty caused or contributed to it.
Settling the case last Wednesday has allowed Mary to get on with living, as opposed to dying, as she puts it.
At home with her family, she chooses not to dwell on what lies ahead.
"We don't want to discuss that day down the road. What if things change in four years' time? What if things change with treatment? You don't want to be final or definite about things," she said.
She prefers to take things day by day. Her overriding focus is on travelling to Portugal to celebrate her son's wedding in August, which means coming off chemotherapy for a while. After that, she will focus on organising a "very special" Christmas.
"You still wake up in the morning and ask, is this a nightmare, is this really real? Am I dying?" she says.
She fights depressive episodes by going out, for lunch with her sisters or with her old work colleagues. She walks the dog, a rescue Collie called Trixie, at 7am, but usually come afternoon, she is wiped out.
"I try to get out because it gets your mind off the seriousness of everything. I mean this is so serious," she says.
Solace comes from simple pleasures, such as the garden that Des (who is recovered and is now back at work) transformed into a low-maintenance bird haven, where finches fight over the bird feeder and a famous Fingal Red Kite briefly swoops in.
From her vantage point, where every day is precious, Mary urges others to take note of pain, chase up tests and keep asking questions. And if the worst comes, she says, treat yourself kindly, be it a nice wig or new clothes.
She has taken her lead from the staff at St Francis Hospice - "It's not about dying, it's all about living," she says.
In a statement, the Mater Hospital said: "Mater Misercordiae University Hospital (MMUH) does not comment on individual patient cases."
Mary and Des have asked the public to support The Irish Cancer Society's Daffodil Day on March 24.