Hospital failed cancer patient

- 07 October 2004;Used with Kind Permission of The Guardian

A high court judge ruled yesterday that a hospital had.breached its duty of care to a former nurse and health visitor who died of cancer two weeks ago. Helen Cooper, 51, who gave evidence from a wheelchair in the last days of her life, believed that her breast cancer could have been detected earlier if doctors had clearly explained to her the advantages of undergoing a second biopsy.

The case centred on the information that doctors give their patients to allow them to make potentially life-saving decisions about their treatment.

Mr Justice Butterfield ruled that the Royal United Hospital Bath NHS Trust was in breach of its duty towards Mrs Cooper. He said staff had "failed to advise her aquately of the risks she faced, the options open to her and their respective merits".

Her husband, nuclear engineer Mick Cooper, of Chippenham in Wiltshire, said after the case that he hoped the ruling would help other people in her situation. "My wife fought this battle not just for herself but everyone else," he said.

"She was a very, very brave person and supported the underdog. 1 hope this will lead to standardised procedures in the NHS. Everyone should get top priority service. We pay for it."

Mrs Cooper, who had worked in the NHS for 34 years, was confused by the information she was given by the hospital, the court was told. After several mammograms — x-ray examinations of the breasts — she had a biopsy in July 2000 to decide whether a lump was cancerous. The result was indeterminate.

According to her lawyer, Sarah Harman, Mrs Cooper got “a series of confusing messages from the hospital".

First a letter appeared to give her the all-clear, and then another offered her a biopsy. She went to her GP to find out what it meant and he wrote to the hospital. It was decided that she would be monitored by mammograms, but it was not made clear to her that the preferred option of the hospital doctors, with the better chance of picking up cancer, was a second biopsy.

The judge ruled that the hospital was in breach of its duty of care by abandoning its preferred option without informing the patient. "I also find they failed to advise her adequately of the risks she faced, the options open to her and their respective merits," Mr Butterfield said. If it had been explained properly, Mrs Cooper would have had the repeat biopsy in October 2000. Her son, Justin, 24, who was in court with his father, said his mother would not have hesitated to have the second biopsy had she understood the situation.

"Her worst fear was breast cancer," he said. If she had been told there was the slightest chance that the biopsy could pick up a cancer, " she would have taken it — no matter how painful".

Helen Cooper gave evidence from a wheelchair days before her death Mrs Cooper knew what breast cancer would be like, he said. She had come to the UK as a nurse from Malaysia at the age of 19 and worked in the NHS for 34 years, in cardiology, geriatrics and orthopaedics before she became a health visitor.

Her breast cancer was finally diagnosed in May 2002, by which time it had spread to her spine. The cancer later reached her liver. The court will now have to decide whether, if Mrs Cooper had undergone the biopsy in October 2000,, the tumour would have been detected, allowing her to be treated and saving her life - Mr Cooper said his mother, who also left a 16-year-old daughter, was a very caring person with a strong religious faith. His parents sponsored four children in the developing world — in Zimbabwe, Thailand, Cambodia and Vietnam.

On the day other death, he said, his mother phoned her solicitor to make sure the court case would not be abandoned once she was dead. "She was adamant she wanted to continue because she thought it was completely unacceptable for a caring specialist unit to behave so badly.

"We used to call her the crusader. She would take on a cause, whether someone else's or, in the end, her own, and not rest until she had seen it through," he said.

Mark Davies, the chief executive of the hospital trust, said they took the ruling very seriously. "I am determined that if there are any lessons to be learned we will learn them, but I am confident this was an unusual and tragic one-off case," he said.