Online consultations put patient safety at risk

24 August 2023

An online consultation failed to diagnose our client’s malignant melanoma which meant a delay in surgery and treatment which could have prevented the neurological dysfunction he suffered and would have extended his life.
Online consultations put patient safety at risk

The facts of the case

Our client had a video consultation with his GP during lockdown in June 2020.  He had a small lump on the top of his back and his wife was concerned about it, telling him ‘I don’t like the look of it’.  At the online consultation the GP couldn’t see the lump properly to assess it, so he asked for a photograph, and from that he diagnosed an epidermoid cyst, (Skin cyst - NHS), advising our client that there was nothing to worry about and it could be taken off when things settle down after the pandemic.  Our client and his wife were reassured.

In March 2021 our client started suffering with loss of function in his left leg and was admitted to hospital, the doctors first thought that he had suffered a stroke, he then started to lose the use of his left arm.  A biopsy was taken of the lump and a diagnosis of malignant melanoma was made. Scans on his brain showed that the cancer had spread, and a large tumour had formed.  The melanoma had also spread to the lymph nodes in his neck.  Our client had surgery to remove the tumour in his brain and underwent radiotherapy and immunotherapy but sadly his condition deteriorated, and he passed away in December 2021.

Expert evidence

Evidence obtained by us showed that the delay in diagnosing our client’s malignant melanoma meant that, although an earlier diagnosis would not have prevented this cancer spreading to his brain, he could have undergone the surgery and treatment at a much earlier stage and would have avoided the neurological dysfunction he had for the remainder of his life, and he would have lived longer.

The expert GP evidence showed that the photograph clearly demonstrated an abnormal appearance, and that our client should have been called in for a face-to-face assessment or an urgent referral for a suspected malignant melanoma should have been made.

Malignant Melanoma

Statistics from Cancer Research UK show that 17,500 people are diagnosed with melanoma in the UK every year and that the ongoing impact of the package holiday boom of the 1960s is likely linked to skin cancer cases hitting a record high in the UK. A leading charity found that the increase is particularly noticeable in over 55s, with cases up 195% since 1990.  DJ Chris Evans has recently been diagnosed with melanoma which has been caught at an early stage and thankfully can be treated.  Chris is urging others to get themselves checked.  Features to look out for are areas/lesions which:

  • change in size
  • area of irregular shape
  • area of irregular colour.


Our client’s wife said:

“We were reassured when the GP diagnosed a cyst and didn’t think anything more of it.  My husband and family went through hell for the last few months of his life, he couldn’t do anything for himself and required round the clock care.  Had he been diagnosed earlier this would have been avoided and he would have had a better quality of life for the time he had remaining.

Shoosmiths pursued and were successful in a case against the GP for negligence and recovered compensation.  More importantly I received an apology and assurances from the GP practice that their practices have changed to prevent mistakes like this happening in the future”.

Sarah Harper, the clinical negligence specialist who acted for the family said: 

“This case highlights the dangers of diagnosing symptoms online.  GPs must be fully aware of what they are looking at and if there is any ambiguity whatsoever then they should undertake a proper face-to-face assessment.  In this case a 14-day cancer referral would have been made and our client would have been seen and treated at a much earlier stage. It is clear from this case that an online consultation and a photograph was not sufficient to make a diagnosis”.



This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024

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