Doctor ‘tried to squeeze lump’

AN Irish mother suffered a “significant delay” in being diagnosed with breast cancer because her doctor refused to accept the lump was anything other than a clogged milk duct.

Detailing the case at the Irish Association of Directors of Nursing and Midwifery (IADNM) annual conference in Athlone, cancer survivor and patient advocate Rebecca O’Malley said the situation was the direct result of a “culture of superiority” in the health service hierarchy.

According to Ms O’Malley, who was also incorrectly given the breast cancer all- clear in 2007, the unnamed patient had repeatedly raised concerns over the lump in the months before the incident.

However, despite the patient’s views, the consultant examining her refused to accept it could be breast cancer and instead attempted to “squeeze out” the lump from her breast.

As a result, the patient was only diagnosed with the life-threatening condition after she demanded a mammogram from other physicians. She has since been given a mastectomy.

“I realise there are various reporting systems in operation within our healthcare system, but they are all voluntary and everyone seems to know that they capture only a fraction of the incidents that actually happen,” said Ms O’Malley.

“There are a number of barriers to reporting errors and unsafe situations but to me, the main one appears to be fear.

“There are fears of repercussions, fears of victimisation, fears of punishment and commonly, for far too many nurses, the fear that temporary contracts won’t be made permanent or renewed if they raise concerns.

“It is this fear which induces a kind of ‘creeping paralysis’ that ultimately ties the tongues and suffocates the consciences of many of our nurses and midwives, the very people we have traditionally looked upon as our natural advocates and protectors,” she said.

Responding to the comments, Dr Deirdre Madden, chair of the Commission on Patient Safety and Quality Assurance, said the situation highlighted the importance of ensuring the group’s 134 recommendations to improve treatment standards are implemented in full.

Among the key issues detailed by the commission are a consistent lack of clinical audits in hospitals, lack of senior clinical leadership and a poor standard of structured incident-reporting across the health service.

Dr Madden, who is also a senior lecturer at the faculty of law in UCC, said there is a need to guarantee the protection of whistle-blowers in the health service.