When a child is diagnosed with a serious illness, one of the hardest questions for parents can be whether it could have been detected earlier.
We recently acted for a family whose young son was diagnosed with a rare genetic condition known as Multiple Endocrine Neoplasia Type 2B (MEN2B). By the time the condition was identified, he had developed medullary thyroid cancer that had progressed to an advanced stage.
Our investigation focused on medical findings from when the boy was an infant and whether they should have led to the diagnosis of MEN2B years earlier.
What Happened?
Our client was only a baby when he began experiencing significant health problems.
In April 2018, when he was less than one year old, investigations into his condition identified intestinal neuronal dysplasia (IND), a disorder affecting the nerves of the bowel.
This was an important finding.
The family’s case was that the diagnosis of IND should have prompted his treating medical team to consider whether there was an underlying reason for his bowel problems, including the possibility of MEN2B.
MEN2B is a rare genetic condition that is strongly associated with medullary thyroid cancer. For children with the condition, identifying it early can be critical because preventative removal of the thyroid may be recommended before cancer develops or progresses.
There was also correspondence in June 2018 concerning the child’s condition and referral to a genetics service. An important issue in the case was what happened to that information and whether it was appropriately received, referred and acted upon.
The child was not diagnosed with MEN2B at that time.
Years later, the family’s circumstances were very different.
Their son was eventually diagnosed with MEN2B and medullary thyroid cancer. By then, the cancer had progressed and the opportunity for the preventative thyroid surgery that may have been available following an earlier diagnosis had been lost.
He was still only eight years old when his medical negligence claim was ultimately resolved.
For his parents, the diagnosis raised a devastating question – could their son’s cancer have been prevented, or treated much earlier, if the warning signs identified when he was a baby had been properly investigated?
Investigating What Should Have Happened in 2018
Answering that question required a detailed investigation of the medical care the child received as an infant.
We obtained independent expert evidence from specialists in clinical genetics and paediatric oncology.
The family’s case was that the finding of intestinal neuronal dysplasia should have led to further investigation for MEN2B. Had that occurred, they alleged their son’s genetic condition would have been diagnosed and his thyroid could have been removed before the cancer progressed.
The Local Health District disputed the claim.
One of the key issues was whether, based on medical knowledge and practice in 2018, the child’s bowel condition should reasonably have caused his treating practitioners to suspect MEN2B.
There was also a dispute about the handling of correspondence recommending involvement from genetics specialists and whether appropriate follow-up occurred.
The case therefore came down to an important question – if the appropriate investigations had taken place when the child was a baby, would his outcome have been different?
The Impact on the Child and His Family
The consequences of the delayed diagnosis were significant.
Instead of undergoing preventative treatment at a young age, the child was living with advanced medullary thyroid cancer and required ongoing treatment.
His future was also uncertain. Expert evidence was required to consider his prognosis, the likely effectiveness of his ongoing drug therapy, his future care requirements and the psychological impact of his illness.
For his parents, watching their son live with a serious cancer diagnosis also had a profound effect.
The case ultimately included separate claims by his mother and father for psychiatric injury and other losses they had suffered as a consequence of what had happened to their son.
Reaching a $3 Million Settlement for the Child
Proceedings were commenced in the Supreme Court of NSW.
After extensive investigation, expert evidence and negotiations, the child’s medical negligence claim settled for $3 million plus legal costs.
As he was a child, the settlement could not simply be agreed between the parties. It required approval from the Supreme Court of NSW, which considered whether the proposed settlement was in his best interests.
The Court approved the settlement.
His parents’ claims were also resolved, with a further $900,000 inclusive of costs agreed in settlement of their claims.
The outcome brought an end to complex litigation for the family and secured substantial compensation without requiring them to proceed to a fully contested hearing.
Delayed Diagnosis Claims Are Not Always Straightforward
A diagnosis being made later than it could have been does not necessarily mean there has been medical negligence.
One of the most important questions is whether an earlier diagnosis would probably have changed the patient’s outcome.
In this case, that meant looking back to what happened when the child was still a baby and asking whether his earlier medical findings should have led to further investigation, whether MEN2B would then have been diagnosed and whether preventative thyroid surgery could have occurred before his cancer progressed.
These questions required evidence from appropriately qualified specialists and careful examination of the child’s medical history.
Similar issues can arise when symptoms, abnormal pathology results, scans, referrals or other warning signs are not followed up and a serious condition is subsequently diagnosed.
Could Your Child’s Condition Have Been Diagnosed Earlier?
Parents do not always know whether something has gone wrong with their child’s medical care.
Sometimes it is only after a serious diagnosis that earlier symptoms, test results or medical appointments take on a different significance.
If you are concerned that warning signs were missed, a referral was not followed up or your child’s diagnosis was unnecessarily delayed, obtaining legal advice can help you understand what happened.
At The Law Office of Conrad Curry, we help families manage complex medical negligence claims.
Our medical negligence team can obtain and review the relevant medical records, seek independent expert evidence and advise you about whether the treatment provided may give rise to a claim.
Time limits apply to medical negligence claims, so it is important to obtain legal advice as early as possible.
