Women win screening test case
Tuesday 16 February 1999
In the first case to come to court because of Britain's biggest cervical smear screening scandal, Mr Justice Peppitt ruled yesterday afternoon that the women were victims of medical negligence at the Kent and Canterbury Hospital. Eight women are believed to have died and at least 30 women had to have hysterectomies after failures at the hospital.
But East Kent Health Authority has denied negligence on behalf of the hospital in a number of cases.
Helen Palmer, 35, of Whitstable, Sandra Penney, 35, of Ramsgate, and Lesley Cannon, 38, from the Isle of Sheppey all claimed that hospital screeners misread their smear tests, and as a result they all contracted adenocarcinoma, a less common form of cervical cancer. All three have had hysterectomies to remove the cancer.
The dispute in the 10-day court case centred on whether cyto-screeners, the laboratory technicians that examine slides, should have been able to spot signs of pre-cancerous material when the smears were taken between 1990 and 1992.
Mr Justice Peppitt, sitting at Canterbury County Court, said: "The screeners had a clear duty of care to their patients to refer any borderline slides to a senior analyst or even a pathologist for checking." This they had failed to do.
Of Mrs Penney's case, the judge said, "In my judgement no competent cyto- screener should have dismissed the possibility that the cells might have been pre-cancerous."
He added that a reasonably competent cyto-screener should have classified the smear as borderline even if it had caused Mrs Penney to suffer short- term distress and possibly another smear test.
In the case of Mrs Palmer, he asked "whether a reasonably competent screener would have been justified" in not spotting the cells were abnormal. He said the screener of Mrs Palmer's second smear test in March 1990 was in breach of his duty of care to Mrs Palmer by reporting it as negative.
The three women will now apply to the court for compensation. The hospital trust has already admitted that the screening department was poorly run, underfunded, poorly managed and the screeners inadequately trained. It has settled 47 cases at a cost of more than pounds 1m but has refused in a number of others to pay compensation.
The judgment against the hospital will have national implications. The East Kent Health Authority had argued that its screeners were comparable with screeners elsewhere at the time. The women's lawyers had argued these standards were not high enough. The women's solicitor, Sarah Harman, said she hoped the ruling would set a benchmark for the standards women could expect from the cervical screening programme.
She said: "I think there are some very worrying aspects that have been heard in evidence from experts and very different views. There are different standards in different laboratories throughout the country and I think some action needs to be taken." She said it was "dreadful" the three women should have suffered in the way they had done.
The judge praised the overall efficiency of the national screening programme and stressed that women should continue to use it.
"This is a case of great concern to women but nothing I have heard justifies worry as this occurred a number of years ago and these screenings represent a fraction of the thousands taken each year. It should also not discourage cyto-screeners, a body of devoted and conscientious men and women who do difficult jobs under testing circumstances," he added.
"Rather it should emphasise they should not assume the agonising responsibility of judging between cancerous and benign cells.
Outside the court Lesley Cannon said: "I'm going to sue, I want compensation, I don't know how much, just loads of money to pay for a brilliant holiday. This verdict means hospitals are going to have to be a lot stricter ... if someone gets a negative result, they should now be able to say it is truly negative."
The director of the NHS trust, Tim Smith, said: "It is too early to say whether we shall appeal."
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