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Delay in Breast Cancer Diagnosis Leads to Death, Million Dollar Settlement | Debary Personal Injury Lawyer

Delay in Breast Cancer Diagnosis Leads to Death, Million Dollar Settlement

More than a year and half after a screening mammogram and nine months after first being seen by her physician for an infection around her armpit, a woman was diagnosed with inflammatory breast cancer.

Despite the findings of a lump and an increase in breast tissue, her physician did not order a follow-up mammogram. After she was diagnosed with breast cancer, she lived just four more years and died at the age of 53.

In this case, the physician and the radiologist settled during trial for more than $1 million.

The 49-year-old mildly obese woman was seen by her doctor for a routine physical exam. Her yearly screening mammograms had all been negative and she did not have a family history of breast cancer.

The physician noted in the woman’s chart that there was “multiple nodularity” of both breasts, but did not say the nodular findings were significant. A previously-scheduled screening mammogram conducted the following month showed no changes in the woman’s breasts.

One year later, the woman was seen again by her physician and diagnosed with hidradenitis (a chronic, pus-producing disease process caused by obstruction of the hair follicles and secondary infection and inflammation of certain sweat glands).

The physician did not document his findings in the woman’s medical chart. The woman was treated with antibiotics, and returned 10 days later, when the doctor noted “hidradenitis improved.” There was not any documentation of a breast exam for the woman included in her medical record for either of these visits.

One month later, at a previously scheduled mammogram screening, the requisition form noted a large increase in her left breast tissue as opposed to right breast. In the box next to the question “Have you or your physician felt a lump in your breast?” was checked YES (on the woman’s previous screening mammograms, this question was checked NO.)

The woman’s mammogram screening results were reported as normal. The hard copy was not initialed by the physician to indicate he had reviewed the screening mammogram report, nor were the results listed in the medical record. He did not talk to the patient about the increased breast tissue and presence of a lump that were noted on the requisition form and hard copy of the report. These facts suggest the doctor failed to review the mammogram report at all.

Seven months later, the patient was again diagnosed with hidradenitis, which resolved with antibiotics. On exam, the doctor noted a large node on the left axilla. When the nodes persisted during two re-examinations over the next four weeks, the patient was sent for a mammogram followed by a biopsy.

The 49-year-old woman was diagnosed with inflammatory breast cancer and had to undergo aggressive treatment. However, she died four years later.

This was a successful medical malpractice case based on these factors:

The physician failed to follow-up appropriately: Given the notation on the requisition form that a lump was felt, along with an increase in breast tissue on one side, the radiologist should have ordered a mammogram, to be followed by an ultrasound if necessary. The physician denied feeling a lump on the physical exam preceding the final screening mammogram; however, presence of a lump was clearly stated on the requisition form in the final report of the screening mammogram that the physician received.

Documentation was poor and incomplete: The abnormalities of the first breast exam, which included multiple modularity, were documented, but were not referenced in future breast exams. If any breast exams were done preceding her annual screening mammograms, they were not documented. The woman’s doctor did not document the findings that led him to diagnose hidradenitis, nor did he document that the hidradenitis had resolved. Following up on unresolved complaints is more difficult if the complaints and their resolution are not documented in the patient record.

Follow-up system was lacking. The physician did not have a good follow-up system for ensuring test results are received and reviewed with the patient. A tracking system should ensure notification of test results to the patient and ensure that all hard copies are initialed by the physician before being filed.

Poor phone records. The office had no records of phone conversations and no written policy or procedure regarding phone calls.

For more on patient’s rights, see the library of articles by Daytona Beach medical malpractice attorney.


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