Case #1076: Colon Cancer
On January 26, the Claimant was referred to the Defendant gastroenterologist. The purpose of the referral was for specific complaints of rectal bleeding. It is alleged that the standards of care therefore required the Defendant to rule out the prospect of colon cancer.
That same day, the Defendant performed a flexible sigmoidoscopy, and took a biopsy of a sessile polyp. The biopsy sample was forwarded to pathologists who rendered a report to the Defendant on January 27, which specifically reported the finding of tubulovillous adenoma with focal high-grade dysplasia consistent with in situ adenocarcinoma. In other words, the pathology report on the biopsy indicated the presence of colon cancer — exactly what the Claimant was concerned about when rectal bleeding was discovered.
On January 28, the Defendant performed a “polypectomy,” supposedly removing the polyp in pieces through a scope. That pathology material was sent for a pathology reading to the Defendant pathologist as well as other pathologists at the Defendant hospital. Contrary to the standards of care, the pathologists read the polypectomy specimens as containing no cancer whatsoever. However, it is alleged that had the pathology specimens been read in accordance with the standards of care, the presence of adenocarcinoma would have been diagnosed, and a simple segmental resection of the Claimant’s colon would have been completed shortly thereafter — virtually assuring a cure.
It is asserted that the cancer present was in an early form and could have been simply removed through surgery. However, the Defendant, contrary to the standards of care, failed to go forward with any additional intervention or treatment. It is alleged that the Defendant, in the initial pathology report, was specifically advised that the patient had a malignancy. Notwithstanding any subsequent pathology report, the standards of care required a referral of the Claimant to a surgeon and oncologist for further consultation as well as intervention. Had that been done, it is alleged that the standards of care would have required the surgeon and/or oncologist to go forward with a simple segmental resection to remove the malignancy which had been diagnosed.
However, contrary to the standards of care, the Defendant failed to intervene as indicated hereinabove, and instead elected to “follow” the malignancy with flexible sigmoidoscopy examinations, etc. However, because the malignancy was growing in the wall of the colon, the Defendant failed to detect through a scope the growth, extension and ultimate metastasis of the malignancy.
Had the Defendant conformed to the standards of care, the segmental resection would have been completed and the Claimant was assured a virtual cure. However, because of this ongoing negligence, the cancer which had been absolutely diagnosed previously, was left to grow, extend and metastasize until it was finally discovered on May 9 — some three and a half years after it was originally diagnosed and left intact. By that time, the cancer had spread to the point that it was Stage IV, resulting in a terminal prognosis for the Claimant.
It is further alleged that had the pathologists reported the presence of the cancer as required by the standards of care, the resection would have occurred and the Claimant cured.