Two screening laboratories have admitted in the High Court that they were in breach of their duty when they each failed to report abnormalities in the smear tests of a woman who later died of cervical cancer.
Irene Teap was 35 when she died in July 2017 after being diagnosed with stage 2 cancer in September 2015. She had received negative smear test results in 2010 and 2013.
Her widower, Stephen Teap, and their sons Oscar and Noah settled their legal claims for personal injuries, severe psychiatric upset, loss and damage on Thursday against the Health Service Executive and the two laboratories. Mr Teap further claimed Ms Teap’s death was caused or permitted to be sustained by the defendants’ negligence and breach of duty.
Texas-based Clinical Pathology Laboratories Incorporated admitted it was in breach of its duty to Ms Teap in failing to report her 2010 cytology sample as abnormal. Had this been picked up at the time, it said in its defence, it is likely that she would have undergone treatment and the pre-invasive condition would have been curative.
The admitted breach “caused and/or contributed to the death” of Ms Teap, the laboratory said.
Breach of duty
Medlab Pathology Limited, with a registered office in Sandyford Business Park, Dublin, admitted a breach of duty in not reporting her 2013 smear sample as abnormal. Had it recorded that high-grade cells could not be excluded, Ms Teap would have been referred for colposcopy and, on the balance of probabilities, she would have been diagnosed in October 2013 with stage 1B1 cancer, it said in its defence.
If this had happened, her five-year survival rate would likely have been 89 per cent rather than 66 per cent when she was actually diagnosed in September 2015, it said.
The HSE admitted it was primarily liable, but denied it was vicariously liable, for the acts or omissions of the laboratories. It said it was entitled to a full indemnity from them. The HSE accepted Ms Teap should have been told of the results of a retrospective CervicalCheck audit.
Mr Teap said he heard from media reports in April 2018 that a retrospective audit had been carried out of smear slides of women who developed cancer and who had been tested under CervicalCheck. He told the High Court he “pretty much lost my vision” when he was informed the next month that abnormalities were found on reviewing Ms Teap’s slides as part of the audit.
He alleged Ms Teap’s consultant gynaecologist had been informed about the review results nearly a year earlier, some three weeks before Ms Teap’s death. When told she had cancer and would die, she had asked “over and over… How did this happen? I did everything right”, he said. The answer given was that there were limitations to screening programmes, he said.
Mr Teap said he felt the HSE obstructed his wife’s ability to seek answers and justice for herself. It was not until three weeks ago, when the defendants altered their defence to admit some liability, that “we got our answer” to her questions.
He said justice for his late wife was “preventing the laboratories and the HSE from burying the truth along with her”. He said he now knows that if the slides were read correctly “she would be alive today”.
‘Dark and disturbing’
Approving the settlement, Mr Justice Paul Coffey said the facts of the case were “dark and disturbing”. He expressed his sympathies to the Teap family.
As part of the settlement, the two boys will each receive €100,000 solatium, a statutory compensation, to be paid to them when they reach adulthood. The court heard other relatives had waived their claim to solatium in favour of the boys. No further details of the settlement were disclosed to the court.
Outside of court, Mr Teap said he has dedicated the last 4½ years to seeking the truth for his late wife. He said Irish women deserve a properly run and well-funded cervical screening programme, while acknowledging hundreds of thousands of lives have been saved by the programme.
Mr Teap called for mandatory open disclosure to be put into law so doctors are obliged to tell the truth.
“The blood of my beautiful wife and the incredible friends I have made who have passed away is on the Government’s hands and those politicians who failed to listen,” he added.
On Thursday night Taoiseach Micheál Martin said there was “no defence” for what happened with the CervicalCheck controversy, and offered an apology to Mr Teap.
“First of all, I fully understand where Stephen Teap is coming from. What happened to him and his family is absolutely devastating,” he said on Virgin Media’s Tonight Show.
“In terms of the CervicalCheck scandal, it shouldn’t have happened, there is no defence for what happened.
“And the labs today have admitted that their misreading of these tests were a causative factor in Irene Teap’s death. Our sincere sympathies and apologies go to Stephen Teap and his family.”
When asked about the failures in relation to governance over laboratories examining smears, Mr Martin said: “I wouldn’t accept it was price over quantity.
“I don’t think it was driven by price, I think it was driven with a desire to get a cervical screening programme established much more quickly than otherwise would have been the case.
“But the key issue of failure to disclose in respect of the audit results was unacceptable. But also in terms of the actual mistakes that were made by labs had a causative effect on the deaths of women, which is shocking in itself.”