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Failure to Diagnose Rectal Cancer

$850,000 – Medical Malpractice/Negligence

Facts

A 37-year-old engineer is diagnosed with late-stage rectal cancer after her doctor failed to rule out cancer when she complained of constipation and GI problems for almost two years.

Defendant doctor of defendant medical group was plaintiff’s primary caregiver. On August 31st, plaintiff, a 37-year-old metallurgical engineer, was seen by Defendant doctor in a 15-minute examination for complaints of nausea and dizziness with exercise for several months. She also expressed concern about a mole on her right pubis. Defendant doctor ordered routine blood work, including a CBC. Results were reported back on September 5, showing clear evidence of iron deficiency anemia, and the need to slightly reduce the patient’s thyroid medication. Defendant doctor saw the thyroid results but not the anemia results.

On January 18th, Defendant doctor recommended iron supplements because the patient’s iron level were low. Plaintiff complied, although she had the side effects of nausea and constipation. Between late February and early July, plaintiff continued to have her previous symptoms of nausea and fatigue but also developed constipation and irritable bowel syndrome. Defendant medical group advised her that she could have some constipation because of the iron supplement.

On July 7th, plaintiff was seen with a complaint that her last two menstrual cycles had been longer but not heavier than normal. Medical group personnel recommended that her IUD be removed and also ordered routine blood work. This time her thyroid level was good but there was evidence of significant anemia.

After plaintiff had her IUD removed on July 23rd, she was told that her TSH level remained good but that her iron level was still low. She was told for the first time that she was “somewhat” anemic. No additional follow-up was suggested or required. Her menses returned to normal within two cycles, but she continued to have gastrointestinal problems over the next several months, including stomach pain within 2-3 hours following meals. She also was constipated.

From September through February of the following year, plaintiff was out of Defendant medical group system as a result of a change in her insurance.

On February 24th, plaintiff called defendant doctor and left a message indicating that she sometimes felt as though she was going to black out. She thought it might be related to the medication Inderal which she was taking for migraines. Plaintiff was not scheduled for an appointment. Instead the doctor changed her dosage of Inderal.

On May 5th, Plaintiff called Defendant doctor indicating she had no appetite at all. A nurse returned the call the next day. On May 9th plaintiff was seen by Defendant doctor with a complaint of lack of appetite, having lost 30 pounds since September, secondary to no appetite. The doctor’s assessment was weight loss in a “compulsive female.” She sent plaintiff to a dietitian for a consult.

Blood work drawn on May 9th showed plaintiff to be severely anemic and hyperthyroid, but the results were not conveyed to plaintiff until May 14th by a partner of plaintiff’s doctor (who had gone on vacation). He advised plaintiff that she was so anemic she should be seen in Urgent Care that day. Blood work was re-run, but the doctor did not see a life-threatening situation. He advised plaintiff to take her iron supplements, decrease her thyroid medication and follow up with Defendant doctor.

Plaintiff called for Defendant doctor repeatedly over the next several days. She was eventually seen on June 17th she was assessed as having severe anemia with constipation, pale and hyperthyroid. The doctor attempted to obtain both endocrinology and OB/GYN consults. While waiting for those consults, plaintiff called the medical group on June 27th indicating severe constipation for two weeks. She was advised to take a laxative as well as encouraged to eat fruits and vegetables.

On July 5th plaintiff was seen in the ER at Defendant medical group. A rectal examination revealed a firm, irregular mass in her rectum. She underwent surgery on July 11th. Surgeons found a 6 cm well-to-moderately-differentiated adenocarcinoma of the rectum, invading the entire bowel wall with one of seven regional lymph nodes positive for cancer.

Allegations/Contentions

This tragedy was avoidable had Defendants complied with the applicable standards of practice and care as well as their own policies and protocols; that the standard of care was repeatedly violated as the personnel at Defendant medical group repeatedly failed to follow up with Plaintiff’s continued evidence of worsening iron deficiency anemia and increasing gastrointestinal symptoms.

Injuries/Damages

Plaintiff underwent a low anterior resection with colostomy. Her life expectancy was less than five years. The plaintiff eventually succumbed to the cancer.

Special Notes

As a family practitioner, Defendant doctor was required to manage a “patient panel” of 3,000 patients, five days a week, every 15 minutes. Additionally, she was required to return patient phone calls as well as handle one Urgent Care Clinic per week, either at night or on a weekend. Physicians at Defendant medical group would frequently not have access to their patient’s primary charts which were kept at another location. The same doctor who missed this diagnosis also missed a diagnosis of appendicitis.


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