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The Health Service Executive (HSE) and two hospitals have apologised to a man who claimed his rare malignant tumour went undiagnosed for nearly seven years. 
The High Court heard on Thursday that Gino Appezzato (50) had settled his legal action for €1.55 million. 
His counsel, Dr John O’Mahony SC told the court that Mr Appezzato had first gone to St Luke’s General Hospital in Kilkenny in 2009 for a scan as he had lower back pain. The October 2009 scan showed a small mass of about 1.3cm in his heart, but counsel said it was incorrectly identified as a lymph node. 
Mr Appezzato was reviewed in St Luke’s Hospital the following month and referred to University Hospital Waterford and seen there, but he was assured there was no reason for concern. He was referred back to St Luke’s Hospital in August 2015 as he had recurrent pain. 
A CT scan in January 2016 showed a very large mass in the abdominal region which was now between 10cm and 13cm in size. Counsel said it was then considered to be inoperable, but he was offered a groundbreaking surgery at St Vincent’s University Hospital in Dublin. 
Before the surgery, Mr Appezzato underwent chemotherapy to shrink the tumour. During the 10-hour long surgery in May 2016, he suffered a cardiac arrest, and shock therapy was required to save his life, counsel said. Part of his heart, his right kidney and part of his gallbladder were removed. 
Mr Appezzato, who lives in Muckalee, Co Kilkenny, said the ordeal has destroyed his life and he is now at a higher risk of recurrence, with a lower life expectancy. 
However, the court heard Mr Appezzato feels he received “impeccable” care from the HSE after being diagnosed and he praised the medical teams at St Vincent’s. The surgeons there are the “reason I am alive today”, he said. 
Mr Justice Paul Coffey said it was “an extraordinary story that the health service that nearly killed him was the same health service that saved his life”. 
In a letter of apology, the HSE and St Luke’s General Hospital said they would like to make an “unreserved apology” to Mr Appezzato and his family “for the failings in care”. 
“We deeply regret the failings and acknowledge the distress these failings have caused you and your family,” it added. 
In a second letter read to the court, University Hospital Waterford said it wished to “apologise unreservedly for the deficits in your care and acknowledge the distress this has caused to you and your family”. 
Mr Appezzato had sued the HSE, which admitted a breach of duty in that the first CT scan of October 2009 demonstrated sufficient findings to require a follow-up with cross-sectional imaging, and this was not done. It was also admitted had Mr Appezato’s cancer been detected earlier he would, as a matter of probability, have required surgery only. 
Outside the court, after the case had been settled, Mr Appezzato said he had been “utterly let down” by the Irish health system and that the delay in his diagnosis meant he required a “highly-aggressive treatment”. He said the treatment left him with permanent and life-changing injuries, and this would not have been the case had the HSE acted on information it knew in 2009. 
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