A cervical screening expert who examined a 2009 smear slide of a woman suing over alleged misreading of her smear tests has told the High Court it took him less than a minute to detect an abnormality.
Dr Michael McKenna said it was "patently clear" the 2009 Ruth Morrissey slide was abnormal.
“I made a judgment it was abnormal within a minute.”
He did not believe the way in which the slide was read by a US laboratory, Quest Diagnostics, was in accordance with good laboratory practice and said it was "not acceptable".
He also said a 2012 slide concerning Ms Morrissey which was tested by another laboratory, MedLab was “inadequate”.
He was continuing his evidence on the third day of a resumed action brought by Ruth Morrissey, who is seriously ill with cervical cancer, and her husband against the HSE and the two laboratories.
Dr McKenna is a consultant cytopathologist in charge of one Northern Ireland’s four laboratories responsible for screening cervical smear tests.
He said in October 2018 he had examined the 2009 Morrissey slide which had been tested by Quest Diagnostics at their lab in Wyoming and came back as negative.
His conclusion was that “you could not have not seen” the abnormality.
“It is unbelievable you would not have seen it,” he added.
He found it difficult to understand that it was not interpreted as abnormal.
“I decided it was abnormal, “ he said. Deciding which category of abnormal takes longer, he added.
Dr McKenna said he would have expected a screener to have identified the abnormality and said it was “not acceptable” that the Ruth Morrissey slide tested by Quest in 2009 was reported as normal.
Misinterpretation
Ms Morrissey (37) and her husband Paul Morrissey, of Kylemore, Schoolhouse Road, Monaleen, Co Limerick, have sued the HSE; Quest Diagnostics Ireland Ltd, with offices at Sir John Rogerson's Quay, Dublin; and Medlab Pathology Ltd, with offices at Sandyford Business Park, Dublin 18.
It is claimed there was failure to correctly report and diagnose and alleged misinterpretation of her smear samples taken in 2009 and 2012.
It is claimed a situation 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 gynaecologist in 2016.
It is claimed she was not told until May 2018 of those review results which showed her smears were reported incorrectly.
The Morrisseys claim that if Ms Morrissey had been told of 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 has admitted it owed a duty of care to Ms Morrissey but not to her husband.
The laboratories deny all claims.
On Thursday, referring to the 2012 Morrissey slide which was tested by MedLab, Dr McKenna said it was inadequate.
MedLab could have made a second slide and that would have taken about 45 minutes, he said.
“It could not be treated as anything other than inadequate,” he told the court.
Patrick Treacy SC, for Ms Morrissey, told the court the 2009 Ruth Morrissey slide which was sent to Quest Diagnostics was tested in a laboratory in Grand Rapids, Wyoming.
It is alleged that was not a laboratory set out in the HSE contract and counsel said their case was the HSE did not know about this laboratory.
The case continues on Friday before Mr Justice Kevin Cross.