A first instance decision from England, Muller v King’s College Hospital NHS Foundation Trust [2017] EWHC 128 (QB) required the court to consider breach and causation issues in a claim alleging delayed diagnosis of a melanoma.

The defendant was found to have breached its duty, as the signs of malignant melanoma were plain to see on the pathology slides: [95].

On causation, at [136] the Court found that on the balance of probabilities, the melanoma had already metastasised by the relevant date, the cancer would have reasserted itself at some point, and therefore the claimant would have had to undergo a sentinel lymph node biopsy and a lymph node dissection at some point, with all the attendant pain and suffering, and approximately the same level of pain, discomfort and disruption, as well as expense and lost earnings, during the recovery phase.

Modest damages were awarded based on differential treatment.

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