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Doctor’s Narrow Focus Delays Cancer Diagnosis, Results in Settlement | Port Orange Personal Injury Lawyer

Doctor’s Narrow Focus Delays Cancer Diagnosis, Results in Settlement

After two and a half years of complaining to his primary care physician about an itchy, non-healing lesion, and being denied a referral to a dermatologist, a man sought out a dermatologist and learned that he had squamous cell cancer.

The cancer resulted in the permanent loss of sexual function for the 50-year-old man and he sued his doctor alleging a delay in diagnosis. The case was settled for more than $500,000.

During his initial visit for a sprained wrist, he mentioned the itchy rash on his penis. The doctor gave it quick look, prescribed medicinal lotion and asked the patient to call if the condition did not improve.

Sixteen months later the patient called his doctor’s office and spoke to a nurse, complaining that a variety of over-the-counter treatments only provided temporary relief. He was instructed to try Spectazole and the doctor noted that in the patient’s file that his daily workout regimen was causing the rash to return and preventing healing.

Three months later the patient called again to complain about the Spectazole not working. His doctor suggested Lotrimin and requested a routine follow-up appointment. Two days later the patient returned and the doctor noted that the rash had improved, but it looked fungal and appeared to be irritated from scratching. The doctor had an informal discussion with a dermatologist in a nearby office, but the patient was not examined. They suggested a combination of Loprox and Lidex.

Five months later, two years after his initial visit, the patient called again, complaining about the prescription not working and asking for a referral to a dermatologist. In the patient’s record, the doctor wrote “It won’t go away unless he stops working out. It is a fungus. Live with it and cream will keep it in check.” The doctor said a dermatologist would say the same thing and declined the referral request.

Two and half months later he was seen by his doctor for a sciatica complaint. He was also treated with Lidex and Diflucan for the persistent penile rash. During this visit the patient said he had stopped his exercise routine due to his cardiac health.

Four months later the patient changed doctors. His new physician documented a long history of an irritated penile rash, with a red raised lesion, unresponsive to yeast and steroid treatments. This PCP referred the patient to dermatology, and prescribed Ketoconazole and hydrocortisone cream twice a day. Three months later, the patient was seen by a dermatologist who diagnosed dermatitis of the penile shaft and prescribed Aclovate cream and Zeasorb powder with instructions to follow up in two weeks.
During the follow-up appointment, in October 2004, the dermatologist biopsied the lesion on the penis, which led to a diagnosis of squamous cell cancer.

This patient’s medical malpractice claim was successful due to these factors:

Ongoing complaints require doctors to investigate additional possibilities. The patient’s rash was referred to as a yeast infection, fungal infection, atopic dermatitis, contact dermatitis and other terms, but these assumptions continued without further examination and despite the fact that various prescribed treatments had failed.

The patient’s request for a dermatologist referral was denied. After six months of suffering through various failed therapeutic trials, the standard of care would have been to refer the patient to a dermatologist. Based upon his doctor’s comments, the patient believed he would have to pay out of pocket for a non-referred dermatologist visit.

The rash was not properly addressed despite the man’s complaints. Skin lesions of unknown origin should either be followed to complete healing in the case of therapeutic trials or biopsied. Telling the patient to “live with” the rash is not appropriate.

The doctor’s recommendations did not take the man’s medical history into consideration. The doctor’s suggestion to stop working out conflicted with the recommendation that the patient had received to continue exercising to counter his heart disease.

The informal consult with the dermatologist was inappropriate. A formal consultation to dermatology should have been done since the diagnosis was unproved and it failed to clear up fully with therapy.

The patient’s medical record was incomplete and inappropriate. In only one entry, over nearly three years of documentation, is the lesion described in any way. The file lists no descriptions of color, friability, wetness/dryness, depth, shape, or other dimensions. The record should offer detailed and updated descriptions and, when appropriate, photo documentation.

For more on medical safety, see the library of articles by Daytona Beach medical malpractice attorney.

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