diff --git a/IRaCIS.Core.Application/Triggers/SubjectVisitTrigger.cs b/IRaCIS.Core.Application/Triggers/SubjectVisitTrigger.cs
index 91cbc248b..8ecbcce82 100644
--- a/IRaCIS.Core.Application/Triggers/SubjectVisitTrigger.cs
+++ b/IRaCIS.Core.Application/Triggers/SubjectVisitTrigger.cs
@@ -182,21 +182,25 @@ namespace IRaCIS.Core.Application.Triggers
 
                         readModule = await _readModuleRepository.AddAsync(newReadModule);
 
-                        if (await _readingQuestionCriterionTrialRepository.AnyAsync(x => x.Id == item.Id && x.IsOncologyReading))
+                     
+                    }
+
+                    var readTumorModule = await _readModuleRepository.Where(x => x.ReadingSetType == ReadingSetType.TumorReading && x.TrialReadingCriterionId == item.Id && x.SubjectVisitId == subjectVisitId).FirstOrDefaultAsync();
+
+                    if ((await _readingQuestionCriterionTrialRepository.AnyAsync(x => x.Id == item.Id && x.IsOncologyReading))&& readTumorModule==null)
+                    {
+                        await _readModuleRepository.AddAsync(new ReadModule()
                         {
-                            await _readModuleRepository.AddAsync(new ReadModule()
-                            {
-                                TrialReadingCriterionId = item.Id,
-                                ReadingSetType = ReadingSetType.TumorReading,
-                                SubjectVisitId = subjectVisit.Id,
-                                ModuleName = $"O-{subjectVisit.VisitName}",
-                                ModuleType = ModuleTypeEnum.Oncology,
-                                ReadModuleAddTypeEnum = subjectVisit.PDState == PDStateEnum.PDProgress ? ReadModuleAddType.PDConfirmation : ReadModuleAddType.FinalVisit,
-                                IsUrgent = subjectVisit.IsUrgent,
-                                TrialId = subjectVisit.TrialId,
-                                SubjectId = subjectVisit.SubjectId
-                            });
-                        }
+                            TrialReadingCriterionId = item.Id,
+                            ReadingSetType = ReadingSetType.TumorReading,
+                            SubjectVisitId = subjectVisit.Id,
+                            ModuleName = $"O-{subjectVisit.VisitName}",
+                            ModuleType = ModuleTypeEnum.Oncology,
+                            ReadModuleAddTypeEnum = subjectVisit.PDState == PDStateEnum.PDProgress ? ReadModuleAddType.PDConfirmation : ReadModuleAddType.FinalVisit,
+                            IsUrgent = subjectVisit.IsUrgent,
+                            TrialId = subjectVisit.TrialId,
+                            SubjectId = subjectVisit.SubjectId
+                        });
                     }
 
                     var visitTaskList = await _visitTaskRepository.Where(x => x.TrialReadingCriterionId == item.Id && x.SourceSubjectVisitId == subjectVisitId && x.TaskState == TaskState.Effect && x.ReadingTaskState == ReadingTaskState.HaveSigned).ToListAsync();