‘A breach of duty’: Apology over errors in BreastCheck screening after woman dies of cancer

National Screening Service accepts delays in case of Kay O’Keeffe ‘materially contributed’ to tragic outcome

The National Screening Service has apologised to the family of a Co Tipperary woman who died aged 63 of breast cancer after abnormalities in her BreastCheck mammograms were not detected.

Two opportunities were missed to intervene earlier for Kay O’Keeffe, the service acknowledged in a letter of apology read to the High Court. The HSE service, which runs the BreastCheck programme, said it wished to acknowledge a breach of duty on its part and to “admit these errors occurred”.

“We accept that this delay materially contributed to the tragic outcome for your wife. We can only express our sincere regret to you and your family for what has happened and its devastating consequences,” said the letter to Ms O’Keeffe’s husband, Patrick ‘Patsy’ O’Keeffe.

The letter, from the National Screening Service’s chief executive Fiona Murphy, was read out as Mr O’Keeffe, from Clonmel, settled a High Court action over his wife’s death from breast cancer six years ago.


Referring to two BreastCheck mammogram images for Ms O’Keeffe in 2011 and 2013, the letter noted an abnormality is seen on both sets of imaging and said Ms O’Keeffe should have been recalled to an assessment clinic for further examination on both occasions.

“I would like to sincerely apologise for the fact that these mammographic abnormalities were not detected. I wish to acknowledge a breach of duty on our behalf and admit these errors occurred and that two opportunities were missed to intervene earlier,” the letter stated.

Found lump

Ms O’Keeffe got the all-clear on her 2011 and 2013 mammograms, but in June 2014 after she found a lump on her breast she was diagnosed with incurable stage 4 breast cancer. The cancer spread to her liver and brain and she died on May 12th, 2017.

It was her family’s case that there was a delay of three years and two months in initiating treatment for Ms O’Keeffe’s cancer. It was claimed that their experts would say that this delay allowed a cancer, that was probably curable in March 2011, to become categorically incurable by 2014.

In a statement read outside the Four Courts by his solicitor Lorcan Dunphy, of Donal T Ryan solicitors, Mr O’Keeffe said responsibility now rests with BreastCheck “to provide the assurance to women in Ireland that such failures can never happen again”.

The admission and public apology, the statement went on, “provides a level of justice for Kay, her husband and her family for these catastrophic failures and their tragic outcome”.

“Kay was a wonderful person who was devoted to her husband and children. She is gone from her family way too soon,” it said.

Independently read

“At two separate meetings with BreastCheck management in 2018, Kay’s husband asked how such failures could have happened. In particular, how could two consecutive mammograms, on the same person, performed two years apart, be misread on each occasion, when every mammogram is read independently by two consultant breast radiologists.

“It is extremely hard to understand how the failure to detect abnormalities on four independent readings occurred and clearly indicates a process failure.”

Mr O’Keeffe had sued BreastCheck and the National Screening Service, both of Parnell Street, Dublin, over the death of Ms O’Keeffe, a mother and grandmother.

It was claimed there was a failure to refer Ms O’Keeffe for a second opinion and a failure to consider or make the correct diagnosis. The High Court heard that liability was initially denied in the case but when the case went to mediation a breach of duty was admitted.

Noting the settlement, Mr Justice Paul Coffey extended his deepest sympathy to Mr O’Keeffe and his family.