Delayed Diagnosis of Esophageal Cancer - Malpractice Wrongful Death
Just prior to jury selection, WRSH partner, Jason Rubin, reached a $1,750,000 settlement in a medical malpractice/wrongful death case involving a delay in the diagnosis of esophageal cancer.
Decedent, then 58 years old, presented to his internist with complaints of chest pain, coughing, and shortness of breath. A chest x-ray and chest CT scan were performed, which demonstrated masses in the lungs which were believed to be lung cancer. A PET scan was ordered and decedent was referred to a pulmonologist. The PET scan also demonstrated abnormal, hypermetabolic areas in the lungs, in addition to a separate hypermetabolic focus at or near the junction of the esophagus and stomach.
Following the PET scan, decedent was evaluated by the pulmonologist, who did not believe that he had lung cancer based upon the appearance of the lesions on CT scan. He believed he likely had pneumonia and prescribed antibiotics and steroids. A follow up chest CT scan was subsequently performed, which demonstrated that the lung masses shrunk— further supporting the diagnosis of pneumonia rather than lung cancer.
Wanting a second opinion, decedent saw another pulmonologist. This pulmonologist noted the results of the prior chest CT and PET scans and recommended an aspiration (which was inconclusive) then biopsy of the lung mass. The biopsy demonstrated cryptogenic organizing pneumonia. Decedent continued to obtain treatment with the second pulmonologist for approximately nine months.
Neither of the pulmonologists recommended any follow up testing or consultation with respect to the abnormal, hypermetabolic focus at the gastroesophageal junction noted on the PET scan.
Approximately one year later, decedent sought the care of a gastroenterologist for complaints of abdominal pain. An upper endoscopy was performed, which demonstrated a suspicious lesion at the gastroesophageal junction— the same area where the PET scan had detected the hypermetabolic focus. A biopsy was performed, which confirmed esophageal cancer.
Decedent thereafter underwent staging tests, which determined that he had Stage IV esophageal cancer. He underwent continuous chemotherapy and other therapy for approximately five years but eventually died of esophageal cancer.
Jason claimed that the two pulmonologists departed from accepted medical practice for failing to refer decedent to a gastroenterologist for evaluation and endoscopy, to investigate the abnormal, hypermetabolic focus at the esophagus seen in the PET scan. If such testing had been done shortly after the PET scan, metastasis of the cancer would have been avoided and decedent would have had a much greater chance for cure or survival.