‘Window of opportunity’ to save woman missed, court hears

A "window of opportunity" to save the life of Ruth Morrissey, was missed due to "unthorough" treatment, a cancer management expert has told the High Court.

Professor Bleddyn Jones said the follow up on Ms Morrissey, who had surgery in August 2014 to remove her first bout of cervical cancer, was flawed and she should have had MRI scans, the “gold standard”, every six months for three years and annually afterwards.

A scan in July 2016 would have detected the recurrence, he said.

Asked by Jeremy Maher SC, was there a probability of a cure in 2016 depending on the location of the cancer, he replied: “Yes.”

“This poor lady is not typical of those who have belts and braces thrown at the cancer,” he told Mr Justice Kevin Cross.

He said “the window of opportunity was missed” and the cancer should have been found in February 2017 “but also earlier”.

By February 2017, it would be so large, it would not be missed, he said, referring to the pelvic wall cancer diagnosed in Ms Morrisey in February 2018 when the tumour was found to be 7cm in diameter.

Alleged misreading

Professor Jones, a professor of clinical radiation biology at Oxford University and an expert in gynaecological cancer management, was giving evidence in the continuing action by Ms Morrissey over alleged misreading of her smear slides in 2009 and 2012 taken under the CervicalCheck screening programme.

She was diagnosed with cervical cancer in 2014 and a recurrence of her pelvic wall cancer was diagnosed in February 2018.

On Friday, Prof Jones said the cancer cells were probably in Ms Morrissey’s pelvic wall before the 2014 operation. He said the follow up after that was “unthorough” and she developed a larger mass “without it being detected, which should never be the case.”

Asked by Mr Maher if a scan would have detected the recurrence, he said it would become visible.

When Ms Morrissey had trachelectomy surgery in 2014, the tumour was so large there would be about 15 per cent risk of recurrence and he would be extremely concerned for that patient not to have follow up care.

If a tumour is larger than 2.5cm, doctors are obliged to offer radiation, he said. He said one treats a patient as a relative and if Ms Morrisey was one’s sister or your daughter, one would do everything possible when there was a 15 per cent risk of recurrence.

Asked about the situation in February 2017, he said, if the larger tumour had been treated, Ms Morrissey could have a long disease-free interval.

Ms Morrissey and her husband Paul Morrissey, of Monaleen, Co Limerick have sued the HSE and the two US laboratories- 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 and a situation allegedly developed where her 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 but she was not told until May 2018 of those review results which showed her smears were reported incorrectly.

The HSE has admitted it owed a duty of care to Ms Morrissey but not to her husband. The laboratories deny all claims. The case continues on Tuesday.