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Case Scenario :
50 y/o male with 30 pack yr. smoking hx has CXR that was read as "4cm large mass in right lower lobe, possible old granulomatous lesion, lesion appears benign, no previous xrays to compare" (not word for word, but you get the point). Was told not to worry about it by PCP--that was September 2000.
Same man, two years later, breaks arm d/t pathological fx. Is diagnosed w/ lung ca w/ mets to bones and brain. Dies four months after dx.
Is anyone at fault?
Nobody is at fault, sometimes this **** just happens?
The man for not following up when told "don't worry"?
The PCP for not ordering a CT and/or lung biopsy?
The radiologist for not suggesting CT or lung biopsy?
Would you be inclined to do anything? Forget about? Further investigate this incident to see if there was negligence?
At some point, my dad (i.e. the patient described above who died) requested copies of his medical record and "hid" them to be found after he died (which just happened). He was the primary income, so after he died $$ was tight. You see where this is going.
As I am less than a year away from finishing med school, I sit here with mixed emotions. Would I want to be sued if I were the PCP or radiologist in this case? No. But isn't that why we carry malpractice insurance? To compensate for our errors?
Just curious as to what people think about this?
Addendum to Post:
I just found out about this yesterday, so I don't have all the facts as I am in a different state than my mom. I am going to get my dad's old records at some point and look over them--mainly out of curiosity, not because I am eager to find info for the purpose of a lawsuit.
Since this is all speculation until his records are reviewed, let's agree that the discussion would not need to proceed if in fact he was told to follow up with a pulmonologist or surgeon, and didn't. In that case, it's was his own damn fault (we never knew he had the initial CXR in 2000 until it was found yesterday by my mom who was cleaning).
After reading Harrison's quickly this morning, I learned that 35% of solitary pulmonary nodules in adults are malignant. If one is younger than 35 y/o, they can have CXRs q 3 months for one year. If the person is older than 35 y/o and has a hx of smoking, a histological diagnosis is necessary--usually via resection of mass (which would be "curative" if no mets).
My question from here is purely economic, and not emotional:
If he would have been diagnosed and treated as stage 1 non-small cell lung ca, instead of diagnosed with stage IV w/ mets, how much longer would he have lived?
I don't know survival percentages off the top of my head, but I think we can safely say he would have lived longer if he was diagnosed and treated in 2000 instead of 2 years later.
If there was gross negligence by the physician(s), would it be unfair to seek monetary compensation for lost wages by the spouse?
$85,000/year x Y years (for whatever the prognosis is for stage 1) minus the two years that he lived unknowningly with the CA
My old man was a professor and actually worked up until 3 weeks before he died.
Whaddya think?
As for the lesion in 2000 not being the cancer, I don't think that could be true. Though I never saw any of his xrays, I do remember one of his docs saying that his mass was in the R lung.
50 y/o male with 30 pack yr. smoking hx has CXR that was read as "4cm large mass in right lower lobe, possible old granulomatous lesion, lesion appears benign, no previous xrays to compare" (not word for word, but you get the point). Was told not to worry about it by PCP--that was September 2000.
Same man, two years later, breaks arm d/t pathological fx. Is diagnosed w/ lung ca w/ mets to bones and brain. Dies four months after dx.
Is anyone at fault?
Nobody is at fault, sometimes this **** just happens?
The man for not following up when told "don't worry"?
The PCP for not ordering a CT and/or lung biopsy?
The radiologist for not suggesting CT or lung biopsy?
Would you be inclined to do anything? Forget about? Further investigate this incident to see if there was negligence?
At some point, my dad (i.e. the patient described above who died) requested copies of his medical record and "hid" them to be found after he died (which just happened). He was the primary income, so after he died $$ was tight. You see where this is going.
As I am less than a year away from finishing med school, I sit here with mixed emotions. Would I want to be sued if I were the PCP or radiologist in this case? No. But isn't that why we carry malpractice insurance? To compensate for our errors?
Just curious as to what people think about this?
Addendum to Post:
I just found out about this yesterday, so I don't have all the facts as I am in a different state than my mom. I am going to get my dad's old records at some point and look over them--mainly out of curiosity, not because I am eager to find info for the purpose of a lawsuit.
Since this is all speculation until his records are reviewed, let's agree that the discussion would not need to proceed if in fact he was told to follow up with a pulmonologist or surgeon, and didn't. In that case, it's was his own damn fault (we never knew he had the initial CXR in 2000 until it was found yesterday by my mom who was cleaning).
After reading Harrison's quickly this morning, I learned that 35% of solitary pulmonary nodules in adults are malignant. If one is younger than 35 y/o, they can have CXRs q 3 months for one year. If the person is older than 35 y/o and has a hx of smoking, a histological diagnosis is necessary--usually via resection of mass (which would be "curative" if no mets).
My question from here is purely economic, and not emotional:
If he would have been diagnosed and treated as stage 1 non-small cell lung ca, instead of diagnosed with stage IV w/ mets, how much longer would he have lived?
I don't know survival percentages off the top of my head, but I think we can safely say he would have lived longer if he was diagnosed and treated in 2000 instead of 2 years later.
If there was gross negligence by the physician(s), would it be unfair to seek monetary compensation for lost wages by the spouse?
$85,000/year x Y years (for whatever the prognosis is for stage 1) minus the two years that he lived unknowningly with the CA
My old man was a professor and actually worked up until 3 weeks before he died.
Whaddya think?
As for the lesion in 2000 not being the cancer, I don't think that could be true. Though I never saw any of his xrays, I do remember one of his docs saying that his mass was in the R lung.
