The High Court has rejected a negligence claim brought by a woman over treatment with Sandostatin LAR, finding that her endocrinologist did not breach his duty of care and that she gave informed consent.
In a judgment delivered on 20 May 2010, Mr Justice O’Neill considered treatment provided between September 2000 and March 2001. The plaintiff alleged negligence and breach of duty by the endocrinologist and the Bon Secours Hospital, Bon Secours Health System.
The plaintiff had a rare pituitary tumour that secreted several hormones. In August 2000, tests showed an elevated IGF-1 level, which the endocrinologist regarded as evidence of excess growth hormone. The judge accepted expert evidence that the result, considered alongside the plaintiff’s medical history, supported prescribing Sandostatin LAR. The treatment was intended to reduce hormone levels and might also reduce the tumour’s size.
The plaintiff experienced vomiting and diarrhoea after her first injection. The endocrinologist halved the dose. She later became seriously unwell and was found to have hypothyroidism. The judge accepted that Sandostatin LAR caused the hypothyroidism, but found that it was not a known side effect when treatment began and could not then have been disclosed as a risk. The plaintiff completed six injections, with the last given in March 2001.
The court considered complaints about the choice of the long-acting drug, monitoring, information given about risks and the administration of injections by the plaintiff’s GP. It found no breach of duty. The judge accepted that the endocrinologist had warned the plaintiff about gastrointestinal upset. He had not warned her about gallstones, but the judge found that risk was not material in the circumstances. The court also found no failure in the monitoring carried out or in the decision to delay further hormone testing.
The judge found that the endocrinologist had not told the plaintiff that her tumour was growing. Although she understood the information about its size and hormone levels as meaning that her health was in grave danger unless she accepted treatment, the court found that this impression was not caused by inappropriate advice or withheld information.
The judgment noted that tests in April and May 2001 showed growth hormone levels within the normal range, and an MRI later that year showed a 10% reduction in tumour size. The court considered the improvement probably resulted from the six injections, while attributing later stability and further shrinkage to radiotherapy.
The court concluded that there was no negligence in the treatment and that the plaintiff’s consent was valid and informed. The judgment does not state a separate damages award or other order.