This page is about one specific failure, a cancer test result that came back abnormal and was then not acted on. That's different from a result that was read wrongly or a referral that was never made. For the general law that applies to every kind of missed result, see our page on test results not followed up. For the wider picture, start with our guide to cancer misdiagnosis claims. Here we stay with the cancer pathway. In cancer, a lost result can shift the disease to a later stage and change what treatment is still possible.

What "not followed up" means in a cancer claim

It means a cancer test result was produced and flagged as abnormal, yet no one reviewed it, acted on it, or told you. The result existed. Nothing happened next. In Ireland this is a recognised route to a cancer negligence claim where the delay caused harm.

This is a different failure from the ones it sits beside. A misread scan was looked at, but the abnormality was missed. A failure to refer means no test was ordered at all. Here the test was done and the abnormal result came back, then it stalled. Doctors call the safe handling of results "closing the loop". A patient who hears nothing shouldn't assume that no news is good news. A result can be sitting unread in a system while a cancer grows.

Why an unactioned result can found a claim

Because the doctor who orders a test owns the result. Under the Medical Council's 2024 ethical guide, the doctor who orders a test must check it happened, follow up the result, act on it, and tell the GP.

That duty is set out in the Medical Council Guide to Professional Conduct and Ethics (9th edition, 2024)^[2]. The legal standard then comes from the Dunne test, the question of whether a doctor did something no competent practitioner of equal standing would have done with ordinary care. A genuine difference of clinical opinion is a defence to some claims. It is no defence to leave a flagged tumour marker or an abnormal scan unread. No recognised body of practice supports ignoring a result that has already come back.

Responsibility does not disappear when a hospital outsources the testing. In Morrissey v HSE^[3], the Supreme Court treated the HSE's duty in the screening programme as non-delegable. It could not pass the blame to the laboratories it had contracted. In the same case, the High Court made a separate award for the failure to tell Ms Morrissey about the audit of her earlier smears. Those results had been known for years before she was told. A known result that is not communicated can therefore be a wrong in itself.

Who is responsible, and who pays?

It depends on where the test was done. A claim usually names the clinician or hospital that ordered the test and failed to act on the result, and the route to payment follows the setting.

For care in a public hospital, the State Claims Agency manages the claim under the Clinical Indemnity Scheme, and the HSE is the defendant. A GP or consultant in private practice is claimed against through their professional indemnity insurer. Where testing was outsourced to a private or overseas laboratory, that laboratory can be a defendant too. More than one party can share responsibility, which is common where a result passed through several hands.

How abnormal cancer results fall through the cracks

Through breaks in the system that handles results, not usually through one dramatic mistake. The State Claims Agency records incidents across publicly funded care in Ireland. It found that most diagnosis incidents arise at the test and investigation stage, and that many involve documentation or communication failures.

Its review of diagnosis incident reporting^[1] found that 79.2% of diagnosis incidents were delayed diagnoses. Across all diagnosis incidents, 52% arose at the test or investigation stage, and the most common reported cause, in 55% of incidents, was a test "not performed when indicated". A further 29% were incomplete or inadequate, mostly because of documentation or communication problems. These are the cracks where a cancer result is lost. The common patterns in Irish cancer pathways include the following.

Several Irish features make these breaks more likely. Urgent cancer referrals run electronically, through systems such as Healthlink. A referral can be downgraded or lost in transit between a GP and a hospital. Imaging sits in the National Integrated Medical Imaging System, where a reported finding can stay unread in a queue. Complex results are meant to be discussed by a multidisciplinary team. A confirmed abnormal result can still slip when no single clinician is named to act on it, and each assumes a colleague has. Where a result is critical, good practice is to flag it urgently and tell the ordering clinician directly, rather than leave it to a routine electronic transfer. When a letter goes to an old address, the patient never learns a sample was flagged.

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How we prove the failure and the harm

By showing two things, that the standard of care was breached and that the breach caused harm. The breach is the failure to close the loop. Causation asks what would have happened to your cancer if the result had been acted on when it should have been.

The digital trail is often decisive. Imaging and laboratory systems keep audit logs. When you request your medical records, those logs show when a report came back, whether a clinician opened it, and how long it sat unread. That turns a vague "the result never reached me" into a documented fact. The records that matter usually include the result itself, the referral and recall history, the team meeting minutes, and any note showing who was meant to act. We then ask an independent specialist to compare two stages, the stage when your cancer should have been caught and the stage at diagnosis. Acting early helps the evidence too, because some systems keep their access and transmission logs only for a limited time.

Some red flags in your own records are worth looking for:

• An abnormal result with no referral or recall letter after it.
• A result marked for filing, with no action noted.
• No sign that the doctor who ordered the test ever saw it.
• Repeated abnormal results over time with no plan recorded.
• A result letter sent to an old address you had moved from.

Loss of chance and stage shift

Cancer claims often turn on lost time rather than a wrong diagnosis. A delay can move the disease to a later stage, reduce the treatment options, and shorten life expectancy. The law on this is the doctrine of loss of chance, and it is fact-sensitive. The Supreme Court recognised it in Philp v Ryan^[10].

The central question is what the delay took away. If acting on the result would likely have meant earlier, less invasive treatment or a better prognosis, that lost benefit is what the claim is about. The strength of the case depends on the medical evidence about how the cancer behaved and what an earlier response would have achieved.

Compensation: what a claim may include

A claim can cover both the financial losses caused by the delay and the harm to your health and quality of life. Figures depend entirely on the facts, and clinical negligence general damages are assessed differently from the personal injuries tariff.

Financial losses, called special damages, can include the cost of additional treatment, care, and past and future loss of earnings. General damages cover pain, the effect on your life, and psychological harm. General damages for pain and suffering are guided by the Judicial Council Personal Injuries Guidelines (adopted 2021)^[7]. Clinical negligence cases are valued on their own clinical facts, and awards vary from case to case. Draft amendments proposing higher figures were approved by the Judicial Council in 2025 but have not been enacted by the Oireachtas, so the 2021 Guidelines remain in force. The Supreme Court in Delaney v Personal Injuries Assessment Board^[9] confirmed the Guidelines bind the courts and that any change needs Oireachtas approval. We do not quote a figure for your situation without the medical evidence, because every case is different.

Open disclosure and the Patient Safety Act 2023

Since 26 September 2024, Irish hospitals and clinicians must tell patients openly when certain serious safety incidents happen. A delayed cancer diagnosis from a mislaid result can be one of them. An open disclosure meeting, though, isn't the same as proof of a claim.

The duty comes from the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023^[5], which brought in mandatory open disclosure for the first time in Irish law. There's a point that often surprises people. The Act protects what is said in an open disclosure meeting. An apology or information given during disclosure^[6] cannot by itself be used as evidence of fault. You still have to prove breach and causation independently, through the records and expert evidence. The Act also lets people who develop cancer after taking part in a national screening programme^[6] ask for a review of their screening. That review can help bring the facts to light.

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Time limits and date of knowledge

The general limit for a clinical negligence claim in Ireland is two years less one day. The clock doesn't always start on the test date. It starts on your date of knowledge, the day you first knew, or should reasonably have known, that negligent care had injured you.

This matters a great deal here. If you were never told a result was abnormal, you couldn't have known. So your date of knowledge often comes much later, sometimes only when a new diagnosis or a records review reveals the earlier result. That can revive a claim that looks out of time. The two-year period comes from section 7 of the Civil Liability and Courts Act 2004^[8]. The date-of-knowledge rule it runs from is in section 2 of the Statute of Limitations (Amendment) Act 1991^[4]. A few further points apply. A child's two years don't start until their eighteenth birthday. Where a delay proves fatal, the family has its own claim under the Civil Liability Act 1961. Clinical negligence claims are also exempt from the Injuries Resolution Board, so a court application is what stops the clock. These rules apply in the Republic of Ireland and differ from Northern Ireland and the rest of the UK. Because dates here are fact-sensitive, it is wise to take advice early.

What to do now

If you think a cancer result was missed, a few early steps protect both your health and any claim.

1. Write down the dates, the test, and who you saw.
2. Ask for your full medical records, including the result and the audit trail.
3. Keep any letters, texts, or portal messages about the result.
4. Speak to your current doctor about the clinical position.
5. Get advice from a solicitor before the two-year clock runs.

How we can help

We look at the cancer pathway, from the first abnormal result to the day you were diagnosed. We work out where the loop was meant to close. If the failure caused avoidable harm, we explain your options in plain terms. If this reflects what happened to you or someone you love, a solicitor can review the records and assess your specific circumstances.

We are Gary Matthews Solicitors, regulated by the Law Society of Ireland, PC No. S8178. Initial consultations are confidential and without obligation, and many clinical negligence cases are run on a no win no fee* basis. You can read what that means, and the standard caveats, on our No Win No Fee page. To talk to someone, call 01 903 6408.

*No win no fee describes how fees are handled and is subject to terms. It does not mean a case is free of all cost or risk. This page is general information, not legal advice, and outcomes vary from case to case.

Common questions

References

1. [1] State Claims Agency. Learning through diagnosis incident reporting (accessed June 2026).
2. [2] Medical Council. Guide to Professional Conduct and Ethics for Registered Medical Practitioners, 9th edition (in force January 2024).
3. [3] Supreme Court of Ireland. Morrissey v Health Service Executive [2020] IESC 6 (March 2020).
4. [4] Irish Statute Book. Statute of Limitations (Amendment) Act 1991, section 2 (accessed June 2026).
5. [5] Government of Ireland. Commencement of the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 (September 2024).
6. [6] HSE National Screening Service. Understanding Part 5 of the Patient Safety Act 2023 (September 2024), and the open-disclosure protections in section 10 of the Act.
7. [7] The Judicial Council. Personal Injuries Guidelines (adopted 2021, and still in force after a 2025 proposed uplift was not enacted by the Oireachtas).
8. [8] Irish Statute Book. Civil Liability and Courts Act 2004, section 7 (accessed June 2026).
9. [9] Supreme Court of Ireland. Delaney v Personal Injuries Assessment Board [2024] IESC 10 (April 2024).
10. [10] Supreme Court of Ireland. Philp v Ryan [2004] IESC 105 (December 2004).

Related guides: Cancer misdiagnosis · Test results not followed up · Loss of chance · Date of knowledge