This year approximately 14% of the 193,000 men diagnosed with prostate cancer will already have advanced prostate cancer at the time they are diagnosed. With screening, including digital examinations and PSA blood tests, many of these men could have been diagnosed while their cancer was in the early stages. A delay until the cancer is advanced not only limits the man's treatment options but also dramatically lowers his chances of surviving the cancer. Consider the following reported case as an example.
At age fifty-six, a male plaintiff underwent a digital examination of the prostate. His doctor felt and documented the presence of a small nodule on the left side of the patient's prostrate. The doctor ordered a PSA blood test. The result was noted to be 3.1 which generally considered to be in the normal range. The doctor did not recommend any additional testing or follow up by a Urologist.
Two years and ten months later, the doctor again conducted a digital examination of the patient's prostate. This time the doctor documented the examination as "normal." The doctor did not order a PSA test during this visit. Approximately six weeks after this, the patient had a PSA test as part of a medical examination required for his insurance. The result was a 5.3 which was interpreted as high. When the patient inquired about the results of his blood work from the earlier appointment with his doctor, the doctor told him that he had not ordered a PSA test as part of that workup and suggested that the patient return to the doctor's office for another PSA test.
The PSA test was redone and the result was a 3.5 which the patient's doctor interpreted as normal and as not requiring any additional follow up. The doctor told the patient he did not need to be concerned.
The next time the doctor performed a complete physical examination of the patient was two years and eleven months later. The doctor again documented that the digital examination revealed a small nodule on the prostate. The PSA test came back with an elevated reading of 4.7. The doctor confirmed reading the report with a signature. The patient underwent a sigmoidoscopy the following moth which noted that the prostate was enlarged. The doctor then spoke with the patient and in the medical record documented telling the patient that the test results were normal. The doctor again failed to order a diagnostic workup and failed to refer the patient to a Urologist.
The doctor conducted the next full physical examination one year and ten months later. By this time the digital examination revealed that the prostate was enlarged, and that it was firm on the left side without a discernible nodule. Following the digital examination the doctor documented a plan to refer the patient to a Urologist if the PSA came back above a 3. The PSA actually came back at 14.1.
The Urologist ordered an ultrasound and biopsy which found prostate cancer on both lobes of the prostate, with primary involvement in the left lobe. A bone scan then found that the cancer had metastasized into the right pubis, the right femur and the right tibia. The patient was thus no longer a candidate for surgery and had to begin taking hormone therapy and a Lupron injection. Statistically, men diagnosed with such an advanced form of prostate cancer have an expected two to three years survival rate.
The patient filed a lawsuit against his doctor for the delayed diagnosis of his prostate cancer. During litigation the doctor admitted that the detection of a nodule during a digital examination was an "abnormal" finding. The settlement included the wife's claim of any future wrongful death action. The law of the state in which the claim arose limits the amount that can be recovered for any non-economic damages to $250,000 and would also limit to $250,000 the wife's wrongful death claim. The law firm that handled the matter on behalf of the patient reported that the case settled for $850,000.
This case illustrates the importance of doctors following the screening guidelines for their male patients. By deviating from the guidelines by not performing the required screening tests and by not following up on abnormal test results either by referring the patient to a Urologist or by ordering diagnostic tests (such as a biopsy) the doctor may be liable for medical malpractice. As the case further illustrates, such a claim, even in a state that limits the amount of recovery, can be substantial.
Author Resource:-
Joseph Hernandez is an Attorney who helps victims of advanced prostate cancer due to medical malpractice. Find out more about advanced prostate cancer cases by visiting his website at http://www.prostatecancerlaw.com
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