Factual background and the court’s judgement
A claim was brought against the Defendant hospital after the Claimant, Ms Baggaley, was mistakenly led to believe that she might be suffering from cancer. The Claimant argued that this belief had caused her severe depression as well as Chronic Fatigue Syndrome (“CFS”).
The Claimant approached her GP after finding a lump on her neck. Laboratory tests were conducted. Following a negligent mix-up, the test results incorrectly showed the presence of ‘subtle abnormal cells’. One – unlikely – possibility was that the Claimant had cancer. Exchanges took place in October 2007 between the Claimant and her doctor following the tests. The Claimant alleged that these exchanges led her to believe that she had cancer, which then caused her mental illness. The tests were subsequently disproven and the doctor on several occasions explained to her that there had been a mix-up.
Whether the Claimant’s mistaken belief had caused her psychological problems and CFS was complicated by the Claimant’s predisposition to episodes of anxiety and depression. A large number of GP visits provided substantial evidence of pre-existing psychological issues connected to the stress caused by relationships, employment, pregnancy, health problems and a road traffic accident.
The expert evidence was polarised. On the one hand, the Defendant’s expert considered that the Claimant had long exhibited an endogenous proclivity to mental illness. On the other hand, the Claimant’s expert contended that the Claimant’s bouts of anxiety and depression merely reflected unusually challenging life events.
The judge held that the Claimant’s medical history showed a high degree of psychological vulnerability and that she had been subjected to periods of prolonged anxiety in the past and was susceptible to future such episodes. Nevertheless, the judge held the Claimant had not been suffering from any active psychological illness before the purported misdiagnosis.
It was held that the misdiagnosis had indeed caused the Claimant to develop psychological problems. However, her medical notes suggested that she subsequently made a prompt recovery. The future deterioration in her mental state took place much later and was as a result of new concerns in her life such as financial worries, weight-gain and relationship struggles. The only time the misdiagnosis caused her any further worry was when she once again found a lump on her neck. However, it was held that this would have caused anxiety notwithstanding the past misdiagnosis. It was significant to this conclusion that the judge did not view the Claimant as a particularly reliable witness. He preferred instead to rely on her medical notes. He rejected her assertions that she was constantly worried following the misdiagnosis and that this culminated in her mental illness.
The result was that no causal link was established between the misdiagnosis and the CFS. The latter materialised only after the Claimant recovered from a short period of depressive illness following the misdiagnosis. The judge awarded a modest sum reflecting the anxiety and distress following the misdiagnosis, totalling £6500. This was far short of the £144,360 that would have been awarded had causation been established.
Points of interest – a medical perspective
This is an interesting case in which the impact of a potential diagnosis of cancer is explored. From the perspective of a Clinical Neuropsychologist it raises a number of interesting themes that can be summarised as follows: