$19.16 Million Chester County Record for Nine-Month Breast Cancer Delay That Forced Bilateral Mastectomy
Won by Ross Feller Casey.
A Chester County jury awarded $18 million (later raised to $19.16 million by the trial judge) after a certified nurse practitioner twice examined a 22-year-old and dismissed her breast lump without ordering imaging, delaying a cancer diagnosis by nine months and forcing a bilateral mastectomy instead of a lumpectomy.
What happened
In March 2018, Kerri Downes was 22 years old and working as a registered nurse in the emergency department at Paoli Hospital when she felt a grape-sized lump in her right breast. She went to Axia Women's Health in Strafford, Tredyffrin Township, on March 13 and again on March 29, 2018. Both times she was seen by certified nurse practitioner Eileen Carpenter.
Carpenter did not order a mammogram, an ultrasound, or any other breast imaging. She documented the mass as consistent with fibrocystic breast changes and told Downes the finding was normal. No referral to a breast specialist was made. Standard-of-care protocols for a palpable lump in a young woman, which call for diagnostic imaging, were not followed.
Nearly nine months passed. In December 2018, Downes received a proper workup: an ultrasound and biopsy confirmed Stage IIB breast cancer, with the disease now spread to three lymph nodes. The delay had eliminated the possibility of a lumpectomy. Downes required a bilateral mastectomy followed by radiation treatment. The spread to her lymph nodes also substantially reduced her statistical chance of cure compared to what an early-stage diagnosis would have offered.
Matt Casey of Ross Feller Casey filed suit against Carpenter and Axia Women's Health on Downes's behalf in December 2019. At trial before Judge Edward J. Griffith in Chester County, Casey argued that Carpenter's failure to order imaging on two separate visits, combined with her false reassurance that the lump was benign, directly caused the catastrophic change in Downes's prognosis. Downes, by then married and hoping to have children, testified about writing letters to her unborn children out of fear she would not survive to raise them. The jury deliberated roughly 90 minutes.
On July 22, 2022, the jury returned a verdict of $18 million. Chester County court officials described it as the largest known civil award in the county's history. Defense counsel moved for a new trial and sought remittitur, arguing the verdict was excessive and that jury instructions were improper. In a 53-page opinion issued that December, Judge Griffith rejected all post-trial arguments, finding the award was not excessive and did not shock the conscience of the court. The judge separately added $1.16 million to account for the delay in receipt of damages, bringing the total judgment to $19.16 million.
Sources
This account is drawn from contemporaneous public reporting and the court record.
- 1.West Chester Patch, July 2022: $18M verdict; names Matt Casey and case facts·Archived copy
- 2.Phoenixville Patch: judge upholds verdict; total rises to $19.16M after damages-delay addition·Archived copy
- 3.Phoenixville Patch, 2022: defense post-trial arguments; names Matt Casey and Jacqueline Promislo·Archived copy
- 4.CPH & Associates (nurse professional-liability insurer), 2022·Archived copy
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