In delayed diagnosis claims involving cancer, the challenge is not simply identifying an oncologist. It is ensuring the expert can speak directly to how disease progression, escalation decisions, and prognosis would have differed with earlier intervention.

In this case, the Claimant presented with worsening left knee pain from July 2024, initially treated as inflammatory or degenerative despite progressive symptoms. It was not until February 2025 that imaging and biopsy confirmed metastatic breast cancer involving the patella.

By this stage, the disease had significantly advanced. The Claimant underwent palliative treatment but sadly passed away in January 2026.

The legal team required expert input that could address:

• The clinical significance of the atypical presentation site
• Whether earlier investigation would have altered the disease trajectory
• The point at which escalation should reasonably have occurred

This level of specificity significantly narrows the available expert pool. Progressing with a general oncology expert risked opinion that did not fully engage with the nuances of metastatic spread or withstand scrutiny on causation.

INNEG was instructed at this stage.

A dedicated analyst reviewed the case in detail, focusing on the pattern of symptom progression, the atypical presentation, and the evidential questions likely to sit at the centre of the claim. This allowed expert selection to be driven by the issues in dispute, rather than discipline alone.

Two consultant medical oncologists were identified and nominated on the same day. Each had directly relevant experience in metastatic breast cancer, including bone metastases and delayed diagnosis scenarios.

This removed the need for extended shortlisting or re-instruction, which is often seen in complex oncology claims where initial expert fit is not sufficiently precise.

As a result, the legal team was able to:

• Progress immediately with appropriately aligned expert evidence
• Focus on causation and prognosis with confidence in the relevance of the opinion obtained
• Avoid the risks associated with overly generalist or misaligned oncology instruction

Outcome

• Two specialist oncologist nominations with directly aligned expertise
• Same-day identification, maintaining momentum in a time-sensitive fatal claim
• No requirement for re-instruction or revision of expert approach

By identifying experts whose experience directly reflected the clinical realities of the case, INNEG enabled early-stage clarity on causation and prognosis, supporting a more robust and defensible approach as the claim progressed.