NHS trust admits liability for seven-month delay in tongue cancer diagnosis

The 48-year-old man, who we will refer to as Neil, developed a tongue ulcer in June 2017. He has Chronic Obstructive Pulmonary Disease (COPD), a group of lung conditions which causes breathing difficulties. His ulcer became more painful, and he found eating to be challenging due to the pain. 

Neil lost weight rapidly and by October that year, his sister wrote to his GP expressing her worries about his wellbeing.  

In January 2018, Neil’s dentist referred him to the Oral Medicine Department at Queen Mary’s Hospital in Sidcup, south east London as he had been suffering from his ulcer for six months and the pain was not improving.  

A biopsy was taken the following month in February to test Neil’s tongue for cancer. He was later told that the biopsy results came back as normal. Despite these results, he continued to experience severe pain from his ulcer.  

Neil was advised to stop smoking and to use a steroid spray on his tongue, which did not improve his symptoms.  

By May 2018, Neil’s health had deteriorated significantly, and he was only able to walk 45 to 50 metres at a time. He had stopped using inhalers that he had been prescribed for his COPD due to concerns that they may be worsening the pain from the ulcer.  

The pain progressed further and in July 2018, Neil could not think of much else. His prescription-strength painkillers did little to ease his symptoms, and the pain spread to the left side of his head.  

Neil’s symptoms took a toll on his mental wellbeing. He had no energy, no appetite and was in constant pain. He was struggling to speak due to the pain and had to write to communicate to his family.  

Between March to September 2018, Neil’s weight dropped to around 44kgs. 

At a routine dental appointment on 11 September 2018, Neil’s dentist was concerned by Neil’s poor health and contacted Queen Mary’s Hospital for an urgent appointment.  

Three days later, Neil was seen by a consultant at the Oral Medicine Clinic at Queen Mary’s Hospital. The consultant was alarmed by Neil’s health and referred him to the emergency department at King’s College Hospital for pain control and fluids, as he was dehydrated and malnourished.  

Neil was transferred onto the hospital ward and given IV fluids, high calorie drinks, and liquid oxycodone, a strong opioid mediation given to manage severe pain. 

An urgent biopsy on 21 September 2018 discovered that Neil’s tongue ulcer was stage 3 invasive squamous cell carcinoma, a type of tongue cancer. His original biopsy from March 2018 was re-reported and was found to contain stage 1 cancer.  

The following month, Neil underwent surgery to remove the tumour which involved removing part of his tongue, a neck dissection to remove affected lymph nodes, and a reconstruction of the area inside his mouth. He also had multiple teeth removed. 

Neil then underwent a six-week course of post-operative radiotherapy which adversely affected his speech, led to painful swelling, and neck tightness. Due to the amount of tissue removed from his tongue, he was unable to take food orally and was fed liquid food through a RIG (Radiologically Inserted Gastrostomy), directly into his stomach, for over 18 months. He further developed multiple infections in his jaw and was diagnosed with osteoradionecrosis, a rare complication from radiotherapy where the bone dies due to radiation exposure. 

Neil continues to suffer from long-term complications including difficulty speaking, neck swelling, neck tightness from scarring, persistent pain in his left jaw, and osteoradionecrosis.  

In 2020, Neil approached the Leigh Day medical negligence team to investigate his case. Liability was admitted  and the focus of the legal investigation turned to quantifying Neil’s claim for damages. Sadly, in March 2024, as his legal team were finalising expert evidence about his current condition and future prognosis, Neil was diagnosed with a recurrence of cancer on the right side of his neck.  

This led to a further surgery, radiotherapy and insertion of another Radiologically Inserted Gastrostomy (RIG) for feeding. 

Medical experts re-examined Neil to update their advice on his condition, prognosis, ongoing needs, and life expectancy.  

The case settled in March 2026 for a substantial six figure sum. 

Leigh Day medical negligence partner Angharad Vaughan said:  

“This was a tragic case. The 6-month delay in diagnosing Neil’s tongue cancer had devastating consequences. Had his original biopsy been reported correctly, his cancer would have been diagnosed much earlier and he would have had far less invasive treatment which would have led to a much better outcome in terms of survival and quality of life.  

"Whilst no amount of money could ever truly compensate Neil for what he has been through, I hope that this settlement will give him financial security going forward.”