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Lack of Screening Results in Colon Cancer Death, Settlement Against Doctor | Ormond Beach Personal Injury Lawyer

Lack of Screening Results in Colon Cancer Death, Settlement Against Doctor

A 60-year-old woman with a family history of colon cancer and history of anemia, weight loss and abdominal pain was never offered colon cancer screening during three years of doctor visits. Unfortunately she had metastatic colon cancer which was not detected because of her doctor’s neglect. She died a month after her cancer was discovered but three years after it should have been discovered.

The woman complained to her long-time physician of blood in her stool, but a stool test was negative. She had never received colorectal cancer screening, but her doctor believed she would refuse screening tests for colorectal cancer and did not offer it.

Three months later she returned complaining of abdominal pain. The physician prescribed Zantac, and noted a plan to obtain a right upper quadrant ultrasound if there was no improvement in her symptoms. Medical records did not indicate if a stool test was done at that time or if the woman was still reporting blood in her stool.

Failing to keep the next two appointments, the woman returned two months later with improvement of her abdominal pain on Zantac and a stable weight. The woman was not anemic, and a CEA test, which indicates cancer of the gastrointestinal system, was within normal limits.

During the next two years the woman saw her doctor for chest, abdominal and back pain, as well as high blood pressure. The physician recorded little in his visit notes, with no evidence of a comprehensive examination during this period or the years prior.

The woman received a comprehensive examination three years after her first complaint of blood in her stool. The physician noted a nine-pound weight loss, but an exam, including gastrointestinal and urinary, was found nothing.

Medical documentation did not include family history although the woman’s sister had died of colon and lung cancer in 1995. The doctor performed a pelvic exam during this visit, yet there is no documentation that a rectal examination was performed.

Recommendations on the lab sheet suggested follow-up to include more blood and stool tests. However, the record did not indicate that this information was ever communicated to the woman.

Six months later, the woman went to the emergency room complaining of chest and abdominal pain. Chest X-ray was positive for pulmonary nodules and suggestive of metastatic cancer. She died from metastatic colorectal cancer a month later.

Both the physician and the medical group settled for more than $800,000 for their failure to provide proper screening and testing, resulting in a delay in diagnosing colon cancer.

This was a successful medical malpractice case based on the following factors:

Standard of care was lacking. The woman did not receive colorectal cancer screening based on her risk, age, presentation, or family history. Current national guidelines recommend that everyone over the age of 50 receive some type of screening for colorectal cancer. Patients with symptoms, such as anemia, weight loss, or rectal bleeding should be referred to a specialist for a complete diagnostic workup. A single FOBT in the office alone does not qualify as a diagnostic workup nor adequate screening.

Family history was not updated. The physician did not know the woman’s sister died of colon cancer during their 20-year relationship, and a family history was not documented.
Family history should be updated annually, as it is subject to change and may affect cancer and disease screening.

The patient was never offered a colon cancer screening test. The physician’s long term relationship with the woman and her history of missed appointments resulted in his making assumptions of her probable refusal for a colonoscopy even though she had been willing to undergo cervical and breast cancer screening. Doctors cannot make this these assumptions. All appropriate tests should be recommended to the patient. Counseling and doctor recommendations along with patient response should be documented in the medical record.

Lack of follow-up. The woman was not notified of the need for follow-up testing for blood work when she returned to the practice for episodic care a month later. Lack of a formal process resulted in failure to follow up on an abnormal test result, even when the patient is in the office with another complaint.

Poor documentation. Family medical history and evidence of discussion of colorectal screening should have been recorded. Documentation was scant and some illegible.

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

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