Articles Posted in Misdiagnosing Cancer

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DGK saw her primary care physician, Dr. Raymond Di Pasquo, for recently developed skin lesions. After having seen Dr. Di Pasquo on Nov. 20, 2001, DGK consulted with a dermatologist, Dr. Robert Signore, who biopsied the lesion on her right lateral thorax on Dec. 3, 2001.

The biopsy was sent to Pinkus Dermatopathology Laboratory, where it was interpreted by the defendant physician, Dr. Darius Mehregan.

On Dec. 20, 2001, Dr. Mehregan reported that the specimen was squamous cell carcinoma or a type of skin cancer; a low-grade malignancy believed to have originated from the neck of the hair follicle. This kind of tumor is reported to rarely progress into an invasive squamous cell carcinoma. From there, DGK was referred to a surgeon specializing in chemosurgery for removal of skin tumors.

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A new study raises questions about whether surgery for early-stage prostate cancer is really necessary — or even advisable. This particular surgery, which often leaves men impotent or incontinent, does not appear to save the lives of those newly diagnosed with the disease, according to a study published in the New England Journal of Medicine.

The study concludes that many men with early-stage prostate cancer would do just as well to choose no treatment at all. A report on the study was carried in the New York Times.

The findings were based on the largest-ever clinical trial comparing surgical removal of the prostate with a strategy known as “watchful waiting.” They add to growing concerns that prostate cancer detection and treatment efforts over the past 25 years, particularly in the United States, have been woefully misguided, rendering millions of men impotent, incontinent and saddled with fear about a disease that was unlikely ever to kill them in the first place. About 100,000 to 120,000 radical prostatectomy surgeries are performed in the United States every year.

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We look to our surgeons in emergencies when we are in pain and need intensive medical attention. Surgeons must obtain written consent from the patient before any operation. The surgeon should fully explain the procedure and perform only what he or she explained to the patient.

Those steps were not followed in the case of T.P., who was awarded $2.397 million by a Cook County jury in a suit against Northwestern Memorial Hospital and Dr. Michael A. West, who performed surgery on her in 2006. T.P. underwent emergency surgery for treatment of cancer when all she actually needed was bed rest and antibiotics.

This case was reported in the July 13 edition of the Cook County Jury Verdict Reporter.
T.P. came to Northwestern Memorial Physicians Group complaining of flu-like symptoms on Aug. 14, 2006 following a recent trip to Jamaica. She was sent by ambulance to Northwestern Memorial Hospital, where she remained for 30 hours. Her condition improved there, but Dr. West, then the hospital’s chief of trauma surgery, decided she might have cancer based on what he considered an unusual appendix on a CT scan. He conducted no biopsy or pre-surgical work up and never told T.P. of his tentative diagnosis.

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In a Cook County medical malpractice lawsuit, the Illinois Appellate Court recently ruled that a hospital could not be held liable for the potential negligence of one of its independent contractors in Lamb-Rosenfeldt v. Burke Medical Group, 2012 IL App (1st), 101558. The case was brought by the decedent’s daughter, who contended that the defendant doctor contributed to the her mother’s death by failing to timely diagnose her lung cancer.

Lee Lamb began seeing Dr. Kathryn Burke in November 2004. However, Lamb had met Dr. Burke on several previous occasions when Dr. Burke visited the hair salon where Lamb worked. And while Lamb did have her own physician at the time, she would still ask Dr. Burke questions about her medical treatment. It was during the course of those conversations that Dr. Burke became aware of Lamb’s medical history, including her diagnosis of lung cancer in 1996. So when Lamb became dissatisfied with her current primary care physician in 2004, Dr. Burke was the natural choice for a replacement.

When Dr. Burke began treating Lamb in 2004, Lamb was not actively being treated for her lung cancer. However, according to the medical malpractice complaint, Dr. Burke ignored all the warning signs that Lamb’s cancer was recurring: weight loss, frequent coughing, swallowing difficulty, fatigue, and aspiration of food. Lamb was ultimately diagnosed with a recurrence of her lung cancer in February 2006; she died just eight months later in October 2006. The complaint alleged that if Dr. Burke had recognized the signs and symptoms of her lung cancer at an earlier date that Lamb could have survived.

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Cancer misdiagnosis lawsuits make up a fair share of medical malpractice lawsuits. However, most of those misdiagnosis lawsuits deal with a delay in diagnosis that results in a fatal outcome for the plaintiff. Whereas in Pamela Chouinard v. Dr. Janis Atkinson, North Shore Pathology Consultants S.C., 08 L 9295, the misdiagnosis claim centered on a false positive cancer diagnosis which led to an unnecessary surgery.

The Illinois medical malpractice lawsuit was brought by Pamela Chouinard following the removal of her thyroid gland. While Chouinard had initially been told the surgery was necessary because she had thyroid cancer, a biopsy taken after the surgery showed her thyroid to be benign and cancer free. Chouinard then sued Dr. Atkinson for misdiagnosing her alleged cancer and causing her to undergo thyroid surgery.

The case begins in July 2006 when 62 year-old Chouinard is found to have an enlarged thyroid gland. In order to determine the cause, she underwent a fine needle aspiration of her thyroid. The results showed multiple nodules on Chouinard’s thyroid, including a cold nodule, which is a common sign of thyroid cancer. Based on the thyroid aspiration results, the reviewing pathologist, Dr. Atkinson, entered a positive finding of malignant cancer of the papillary thyroid.

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It is common knowledge that the earlier cancer is diagnosed, the greater the chance of survival. However, we continually see medical malpractice lawsuits where a treating physician failed to recognize the signs and symptoms of cancer in a timely manner. The Cook County medical malpractice lawsuit of Carmela Sahagun v. Allan Aven, M.D., et al., Case No. 08 L 5346, is yet another example of a failing to diagnose cancer in its early stages.

Forty-six year-old Carmela Sahagun presented to Dr. Aven, her primary care physician, complaining of a lump in her left breast as well as a hardness near her breast bone. In order to pinpoint the problem, Dr. Aven referred Sahagun for a CT scan of her chest. The diagnostic test returned signs of a 1.9 cm mass in her left lung; the radiologist further indicated in his report that he suspected the mass might be malignant.

Upon receiving the CT scan results, Dr. Aven appropriated consulted with a Dr. Loren, a surgeon, who recommended a breast biopsy to rule out breast cancer. In addition, Dr. Loren indicated that if the breast biopsy was negative for malignancy, then he would recommend a lung biopsy to rule out lung cancer. Dr. Loren then performed the breast biopsy on Ms. Sahagun, the results of which were negative. However, rather than preforming a lung biopsy, Dr. Loren dismissed Ms. Sahagun from his care and never saw her again.

Ms. Sahagun returned to Dr. Aven for further care and treatment. Over the course of the following year, Ms. Sahagun presented to Dr. Aven’s office on several occasions, complaining of a cough and chest pain at each visit. However, despite these complaints and despite Dr. Loren’s recommendation, almost a whole year passed before Dr. Aven finally ordered a lung biopsy. By this time, the lung biopsy revealed that Ms. Sahagun had Stage IV lung cancer.

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Medicine is a healing profession; as patients we look to our physicians to cure our ailments and relieve our pain. However, in order to heal us, doctors must first diagnose the problem – a quick and speedy diagnosis is often the key to a successful recovery. Likewise, when there is an unnecessary delay in diagnosis, oftentimes the outcome is not very favorable for the patient.

Take for instance the case of 76 year-old Shirley Cyborski, who died as a result of the failure to diagnose her colon cancer for over a year. The medical lawsuit resulting out of this misdiagnosis of cancer, Estate of Shirley Cyborski v. Advocate Health and Hospitals Corp., et al, No. 08 L 6447, was recently settled for $2.05 million.

In 2006, Shirley presented to Advocate South Suburban Hospital for a barium enema examination. This exam is typically performed when a patient experiences a change in bowel habits, has abdominal pain or rectal bleeding, or if there is a suspicion that the patient has diverticulitis or polyps. An x-ray of Shirley’s colon was taken at the time of the barium enema exam, which showed a mass in her colon. However, the colon mass was not reported and therefore her cancer went undiagnosed.

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A recent Cook County jury verdict of $1.5 million was granted in a failure to diagnose breast cancer lawsuit. The Illinois medical malpractice case was brought against a family doctor by the surviving family of a 32 year-old woman who died from metastatic breast cancer in Estate of Lorraine Hollister v. Northwest Associates for Women’s Healthcare, P.C., et al., 05 L 8872. Hollister’s estate alleged that the family practice physician had elected not to run tests that would have diagnosed the breast cancer three months earlier and that this delay decreased the effectiveness of its subsequent treatment.

While three months is typically a very short time in terms of a failure to diagnose breast cancer lawsuit, there were some special circumstances in Hollister . For one, Hollister first complained of pain and discharge from her breast when she was seven months pregnant. During that visit the defendant, Dr. Wener, did not actually perform an examination of her breasts. Instead he simply told her that changes in her breasts were common during pregnancy. No further examinations of her breasts were done during any of her further prenatal visits and her breast cancer was not found until her 6 week postpartum visit.

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Several studies have recently investigated the dangers of different radiology scans and the possibility of radiation overexposure. While many of these radiology scans are important diagnostic tools, research has suggested that many physicians are unaware of the dangers of several different scans, or else are poorly informed about the inherent risks.

Radiology scans are an important tool in screening for breast cancer and allowed physicians to diagnose breast cancer much earlier, thereby increasing the cancer patient’s hope of survival. However, depending on the type of radiology exam used the degree of radiation exposure varies drastically. For example, a typical mammogram increases a woman’s risk of developing breast cancer by 1.3 times per every 1,000 women.

A mammogram is the standard diagnostic exam to diagnose breast cancer, however, there are additional radiology exams that doctors might order if the mammogram fails to provide a clear diagnosis. Of of these exams, the breast-specific gamma imaging (BSGI) increases a woman’s risk of developing breast cancer by 20 to 30 times and the positron emissions mammography (PEM) increases the risk by 23 times. Also, while radiation exposure during a traditional mammograms only increases the risk of developing breast cancer, the BSGI and PEM also increase the risk of cancer in other major organs, i.e. the bladder, gallbladder, kidneys, etc.

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Breast cancer is one of the most common forms of cancer for American women, coming in just second behind lung cancer. According to www.breastcancer.org, one in every eight women in the U.S. develops some form of breast cancer. Like any form of cancer, a delay in diagnosis or a misdiagnosis of cancer can have a negative effect on a patient’s outcome.

Once breast cancer is diagnosed, the typical treatment for breast cancer involves surgery, chemotherapy, and radiation. However, a new study unveiled at a Chicago meeting of the American Society of Clinical Oncology (ASCO) could change the standard for breast cancer treatment. TARGIT-A study is an international study of breast cancer clinical trials involving over 2,000 breast cancer patients. The participants were women 45 years-old and up who had been diagnosed with invasive ductal breast cancer and were undergoing breast-conserving surgery.

Traditionally patients who elect for breast-conserving surgery undergo whole breast external radiation therapy for up to 6 1/2 weeks following surgery. However, the TARGIT-A clinical trials studied the effects of targeted radiation administered during the surgery. The radiation is administered in a single dose and targets only the area of the breast with cancer instead of the whole breast. Half of the studies participants underwent the traditional post-op radiation while the other half received the targeted radiation therapy during surgery. The TARGIT-A study found that the targeted therapy group did somewhat better overall than the traditional radiation group.

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