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Nasal cavity tumour was missed by radiologists looking for confirmation of multiple sclerosis symptoms

A former nurse has settled a case after radiologists failed to spot a nasal tumour when they were looking for signs of multiple sclerosis (MS) in three separate brain scans.

Posted on 13 October 2022

As a result doctors failed to diagnose the cause of the neurological symptoms that they believed were pointing to multiple sclerosis in the patient.

The nurse, who we have called Catherine, was referred for scans three times after she began to suffer typical symptoms of MS, such as tingling and loss of power in her legs.

However, each scan was reported as normal in that radiologists spotted no signs of MS in the brain.

It later became clear that the scans, carried out over a span of three years, had revealed a tumour increasing in size in Catherine’s nasal cavity, just outside the brain.

By the time the mass was identified, it had grown into bone and so surgery to remove it was complicated, with devastating cosmetic consequences for Catherine.

The extent of the damage caused by the tumour could not be corrected surgically so Catherine has had to resort to wearing prosthetic face coverings to conceal and protect a large facial disfigurement.

Catherine instructed Leigh Day clinical negligence solicitor Henry Dyson who settled the case on her behalf.

The hospital trust quickly admitted the error in not spotting the tumour sooner but did not fully accept the extent of the consequences of it. Nevertheless, Henry was able to negotiate a settlement that he said reflected that the trust must have accepted Catherine’s case.

Henry said the case demonstrates that interpretation of radiology imaging is subject to failures of reasoning by radiologists.

He explained: “These failures of reasoning have been studied and they have been categorised into by type. One quite well known problematic mindset is “confirmation bias” where the radiologist looks for signs to confirm a favoured diagnosis rather than looking for signs that would assist with what ought to have been a competing diagnosis.

“Less well known biases are, to satisfy a previously written report or to make a diagnosis being motivated by previous error. All are examples of the ways that the human mind can deceive itself into illogical conclusions. In this case, the error could be categorised as “inattention bias”, that is where a feature is in plain sight, but located in an unexpected area of the scan. In Catherine’s case, the tumour in her nasal cavity was just not noticed because the radiologists were looking for symptoms of MS in her brain scan."

“We are glad that the case has now settled so that Catherine is able to make the best of her life with her young family.”

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