Articles Posted in Misdiagnosing Cancer

When treating cancer the goal is always to obtain as early a diagnosis as possible so as to give the cancer patient the best possible odds. However, sometimes an early diagnosis is not possible. Sometimes there are no warning signs that something is wrong until the cancerous tumors have reached a later stage in development. But sometimes the warning signs are missed and the cancer is misdiagnosed as something else, in which case there would be an Illinois medical malpractice claim for failure to diagnose cancer.

A recent settlement of an Illinois woman illustrates this point. The Cook County resident filed an Illinois medical malpractice lawsuit against her orthopedic surgeon for a failure to diagnose cancer in her elbow. The delay in diagnosis required an amputation of her right arm in order to try and halt the cancer from spreading. However, this strategy did not work and the cancer metastasized to other areas of her body within the following year.

In order for there to be an Illinois medical malpractice case regarding a delayed diagnosis of cancer there needs to be evidence in the cancer patient’s medical records that medical professionals missed clear signs of the patient’s cancer. For this particular woman that sign came in the form of an MRI of her right elbow.

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For many years, radiation therapy has been considered one of the standard treatments given for cancer patients with more than half of all cancer patients receiving some type of radiation therapy. And while radiation does help save many lives, it also presents serious risks for patients and may cause life-threatening injuries or result in potential Illinois medical malpractice.

Therefore, when radiation is used, safety rules must be strictly adhered to because sometimes even the most powerful and technicologically complex machines go awry. And while new technology allows doctors to more accurately attack tumors and reduce certain mistakes, its complexity has created new possibiliities for error through software flaws, faulty programming, poor safety procedures or inadequate staffing and training. When those errors and medical negligence do occur they can be devastating.

Hospitals and doctors trust computer systems and software to apply radiation in many cancer victims. However, there is no single agency that oversees medical radiation and no central clearing house of cases. Furthermore, radiation accidents are chronically underreported, and some states, including Illinois, radiation accidents are not required to be reported at all.

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Oftentimes cancer medical negligence cases in Illinois hinge on a failure to diagnose cancer in a timely manner. However, a recent Chicago wrongful death settlement deals with a different type of medical negligence surrounding a cancer patient’s treatment. In this case a woman with endometrial cancer died as a result of a perforated bowel, which her estate claimed was the result of her receiving 50 percent more radiation than was necessary.

Decedent Patricia Quirk was diagnosed with stage three endometrial cancer and received all of her radiation treatments at Chicago’s Little Company of Mary Hospital. While the first third of her radiation treatments were appropriate, it was the last two-thirds of her radiation treatment that resulted in the Chicago hospital’s medical negligence. In essence, the decedent was ‘over-radiated’, receiving two times as much radiation at each treatment than was necessary and safe.

Even radiation given in appropriate amounts comes with some negative side effects, including nausea, fatigue/malaise, and hair loss. Yet when given in overwhelmingly large amounts, radiation can have disastrous effects on one’s body, as the decedent’s case unfortunately illustrates. The large doses of radiation eventually caused decedent’s bowel to perforate, or tear, which resulted in a blood infection and her eventual death.

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The Illinois Appellate Court affirmed a Cook County medical malpractice jury verdict in favor of the defendant doctors regarding the death of an orthopedic surgeon from an allegedly misdiagnosed malignant nasal polyp. The plaintiff’s appeal had focused on alleged violations of the Dead Man’s Act. Agins v. Otolaryngology Group, Ltd., et al., No. 1-08-3207.

The facts of the case begin when the decedent presented to an otolaryngologist complaining of a severe nose bleed for six days straight. On examination, it was found that the decedent had a 5-millimeter opening to the airway on the right side with severe scarring and a polyp on the anterior part of his right nose. The bleeding was stopped by the doctor through cauterization and the decedent was advised to get a CT scan and referred to another doctor with more expertise.

The decedent continue to follow up with the same physician group over the next few months. Then about five months later the decedent followed up with yet another physician who diagnosed the polyp as neuroblastoma cancer. While the polyp was removed, the decedent died from the cancer two years later.

In the Cook County medical malpractice lawsuit brought by the decedent’s widow, it was claimed that the otolaryngology group that the decedent saw several times during the summer of 2000 and who had cauterized the decedent’s nose bleed but did not otherwise evaluate or treat the decedent’s condition, which in turn led to the failure to diagnose the cancer. However, the defendant doctor claimed that he never saw the decedent in his office.

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A Cook County resident filed a medical negligence lawsuit against a neurosurgeon and neurologist who allegedly failed to correctly diagnose a cancerous growth on the man’s spine. The delay in the diagnosis allowed the tumor to grow larger, which resulted in partial paralysis and permanent neurological deficits.

This particular Chicago medical malpractice lawsuit demonstrates the importance of a timely diagnosis. A review of the case facts indicates that if this man’s tumor had been diagnosed earlier that his resulting paralysis would not have developed to the same degree of severity. This issue of a delay in diagnosis lies at the center of many Chicago medical negligence cases.

The 50-some year-old male presented to the physicians at NorthShore University Health System, f/k/a Evanston Northwestern Healthcare, with complaints of lower back pain and leg numbness. An MRI was ordered, which did in fact show the cancerous growth on the spine. However, the neurosurgeon didn’t identify the growth and the neurologist reportedly didn’t view the MRI film prior to reaching the incorrect diagnosis.

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A woman brought an Cook County medical malpractice lawsuit against her gynecologist for a failure to diagnose her breast cancer in a timely manner. The woman had been seeing the defendant gynecologist regularly since the mid-1980s, but the diagnosis was not made until May 2000, at which point the woman was diagnosed with Stage III breast cancer. The Illinois Appellate Court upheld a jury verdict in favor of the plaintiff, rejecting the defendant’s arguments. Dienstag v. Margolies, No. 1-06-1558.

As early as 1991 the woman underwent a breast biopsy after her left breast showed an area of calcification. While that biopsy returned benign, i.e. non-cancerous results, the results did show atypical ductal hyperplasia. Furthermore, the woman was at an increased risk for developing cancer due to a family history of cancer.

Following the ’91 biopsy the woman underwent annual mammograms to screen for possible breast cancer. Also significant is that in 1998 her gynecologist prescribed estrogen, which could increase the risk for breast cancer, to alleviate menopause symptoms.

The following November, the plaintiff began to complain to her gynecologist of breast tenderness and enlargement. However, on exam the doctor could not feel any dominant lump so continued her estrogen treatments. Then in May 2000, the gynecologist was able to feel a palpable lump in her breast. At that point she was referred to a surgeon for another breast biopsy. This time the results were malignant.

At that point plaintiff was diagnosed Stage III breast cancer, which is fairly progressive. She required a modified and radical mastectomy to entirely remove her left breast and any involved lymph nodes. She later had reconstructive surgery.

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Two years ago The New York Times published an article dealing with chemo brain, a type of mental fog experienced by cancer patients. Recent research has indicated that this phenomenon might be more widespread than previously believed.

While memory and concentration problems are common among chemotherapy patients, for most these effects are short-term and their cognitive function returns to normal. However, for about 15 percent of these patients the memory impairment is prolonged. It is these patients who are suffering from chemotherapy-induced cognitive impairment, or “chemo brain”.

Many studies are being done to try and pin down the cause of chemo brain. Some researchers are exploring whether there is a connection between hormonal changes from chemotherapy and chemo brain, while others are examining which drugs have the strongest links to chemo brain. Yet there are some therapists who argue that chemo brain is the result of the psychological strain of cancer and can be attributed to anxiety, depression, stress, fatigue and fear rather than direct effects of chemotherapy on the brain.

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A $2 million settlement was awarded to the family of a 58 year-old man who died when his lung cancer went undiagnosed. The Illinois wrongful death lawsuit was filed against the decedent’s family practice physician and an emergency medicine physician who provided treatment at Alexian Brothers Medical Center. The Cook County settlement was reached before this failure to diagnose cancer case went to trial.

The decedent’s estate claimed that the Alexian Brothers emergency room physician had misread a chest x-ray taken of the decedent. However, the same film was correctly interpreted by a radiologist the following day as showing a lesion on his lung. The hospital failed to notify the decedent regarding the discrepancy in the interpretation. The decedent’s family physician became involved in the malpractice after receiving a faxed copy of the correctly interpreted radiology report, but still failed to notify the patient of the relevant findings.

As a result of the incorrect reading the man’s lung cancer went undiagnosed for 13 months. Because of the lengthy delay when his lung cancer was eventually diagnosed it was in Stage IV, giving him an extremely poor prognosis. The decedent died about three years after the initial emergency room visit.

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A new DNA test has been developed by Qiagen to identify the human papillomavirus (HPV), a virus found to be associated with cervical cancer. Scientists state that this new test is an improvement on current testing methods and might eventually replace the Pap smear test as a way to diagnose HPV.

Early diagnosis is key in fighting all types of cancer, including cervical cancer. In fact, the most common pitfall doctors fall into regarding patients with cancer is failing to diagnose cancer early enough to provide treatment. This new test could reduce the number of missed cervical cancer cases and improve cancer patients’ outcomes.

The optimism around this new DNA test is based on the results of an 8-year study of 130,000 women in Indian that was recently published in the New England Journal of Medicine. The study, financed by The Bill and Melinda Gates Foundation, revealed that a single screening with the DNA tests met all the same standard as all other methods of early diagnosis of cancer.

Similarly, a study by the University of Chicago reports that a predictive model based on family history of breast or ovarian cancer can aid genetic counselors in diagnosing breast cancer in African women. Development of genetic testing for different ethnicities is important because research shows that genetic mutations vary among racial and ethnic groups.

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Recent studies have exposed inconsistent and inaccurate results of breast tissues tested for cancer, which has led to the misdiagnosis of cancer. The most troubling aspect is that thousands of women may have failed to receive the proper treatment because of errors in two laboratory tests.

One of these laboratory tests is Her-2, which is used to help determine how aggressive a breast cancer tumor is. The test is done not to diagnose cancer, but to help decide on the proper treatment course once breast cancer has already been diagnosed. If the test is positive then the patient likely has an aggressive tumor that will not only respond poorly to hormone treatment, but to chemotherapy as well.

So these patient will then be treated with Herceptin therapy. Herceptin is an FDA-approved drug that works at slowing the growth of aggressive tumors and at destroying cancerous cells. However, in order to be a candidate for this type of treatment one must first test Her-2 positive because the drug only focuses on Her-2 genes.

The introduction of this drug was a breakthrough- by focusing on a subset of cancer patients the drug was more specific and thereby more effective for its subset. However, because one must first be diagnosed as Her-2 positive before receiving the drug it is crucial that Her-2 testing is accurate. And right now that isn’t the case.

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