'Missed opportunity' to treat woman 'on balance' pre-cancer was present in 2012, expert tells cervical cancer case

There was “a missed opportunity” to treat Ruth Morrissey when “on balance” pre-cancer was present in 2012 an expert has told the High Court.

Cervical cancer on the balance of probabilities” was there in  2012 when a smear slide tested by MedLab laboratory was reported as negative, Dr Michael McKenna said on the fourth day of Ms Morrisey’s action against the HSE and two US laboratories over the alleged misreading of her cervical smear slides.

Ms Morissey, who is seriously ill with cervical cancer, was diagnosed with the disease in 2014, which reoccurred last year.

In court on Friday, Dr McKenna who is consultant cytopathologist in charge of one of the North’s four laboratories responsible for screening cervical smear tests, said if Ms Morrissey had been brought back three months after MedLab test in 2012, he believes a test would have given an abnormal result, whether high or low grade.

The recommended recall of three years on the MedLab test, he said was inappropriate and there was a missed opportunity to refer Ms Morrissey for treatment.

“The recording of the sample by MedLab fell below the acceptable standard of care,“ he added.

Dr McKenna said he knew the 2012 slide was going to be inadequate before he tested it. 

He said 5,000 cells are required on a smear slide “for you to be certain” and he considered the 2012 MedLab slide to be inadequate and scanty. He added that it took him less than a minute to decide the smear test was abnormal.

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 Ltd, with offices at Sir John Rogerson’s Quay, Dublin, along with Medlab Pathology Ltd with, offices at Sandyford Business Park, Dublin 18.

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.

A situation it is claimed allegedly developed where Ms Morrissey’s cancer spread unidentified, unmonitored and untreated until she was diagnosed with cervical cancer in June 2014.

It is further claimed a review of the 2009 and 2012 smears took place in 2014 and 2015 with the results sent to Ms Morrissey’s treating gynecologist in 2016, but she was not told until May 2018 of those review results which showed her smears were reported incorrectly.

The Morrisseys further contend that if Ms Morrissey had been told the results of the smear test audits in late 2014 or early 2015, she would have insisted on an  MRI and other scans.

The HSE, the court has already heard, admitted it owed a duty of care to Ms Morrissey but not to her husband. The laboratories deny all claims.

Dr McKenna said cervical screening is not to test for cancer but to detect changes before you get cancer.

He said when he examined the 2012 MedLab under the microscope he observed a group of cells which were stained darker and were hyperchromatic, which he said is one of the features “that could lend itself to not  being benign”.

One group of cells on the slide would have been interpreted as abnormal.

Dr McKenna agreed with counsel for Ms Morrissey, Patrick Treacy, the Republic of Ireland is the first country which has outsourced its cervical screening to two private multi national companies.

The case resumes on Tuesday.

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