Thursday, February 16, 2012

PCP And Urologist Fail To Detect Man's Prostate Cancer For 5 Years by Joseph Hernandez

Prostate cancer is a dreadful disease. Even if not perfect doctors use diagnostics tests to doctors to establish if a patient has the cancer. But as a consequence of the chance of false negatives (a negative test result even though the patient in fact has cancer) doctors have to follow up and redo tests as appropriate if patient symptoms and screening tests keep showing the possibility of cancer. The failure to do so may reslt in a malpractice claim.

In one documented case a man communcated to his family physician that he was having urinary frequency and burning. The doctor began the man on antibiotics and refered him to a urologist. The urologist did a cystoscopy which revealed that the individual had an enlarged prostate. The urologist also ordered a PSA blood test which came back a 16.3 (anything higher than a 4.0 is normally considered to be abnormal). As a result the urologist performed a biopsy 2 months later. The biopsy was read by a pathologist as exhibiting no sign of cancer.

The subsequent year the man returned to the urologist. On this occasion the PSA blood test was a 2.9 (generally considered to be normal). The urologist diagnosed the patient with BPH (a benign enlargement of the prostate). After 3 months the man saw the PCP for fever and nocturia (having to urinate during the night). The physician began him again on antibiotics. A follow up urine culture showed up negative. The PCP consequently referred the individual back to the urologist. The urologist ordered a PSA test which registered a 6.4 (again, high).

A biopsy examines parts of the prostate. As a result, a biopsy may not catch the cancer. Yet, the urologist decided to depend on the prior year’s biopsy and to not do another one as a follow up. Rather, the urologist did nothing to do anything more regarding the male's complaints and abnormal PSA.

The next year the man went back to his primary care physician. His symptoms including nocturia persisted. On physical examination the doctor noted that the individual had a highly enlarged prostate. Still, the physician did not do another a PSA or re-refer the individual to a urologist. Standard blood testing 4 months later showed that the person's PSA was at 7.4 Neither physician followed up in any way.

One more year goes by and now the family doctor documented that the PSA level was 9.8 Again, no follow up or referral to a urologist. Yet another year and the man continues to have problems with nocturia. This time the PSA was 9.7 No follow up and no referral. On the fifth yea following the male patient's earliest claims of urinary problems the family doctor again documented a appreciably enlarged prostate gland and a PSA that had reached a 31. The doctor finally refered the patient back to the urologist.

The urologist verified that the patient’s prostate was enlarged and put the man a 2 week regimen of antibiotics to be followed by an additional PSA blood test. After the PSA test was done two weeks later it showed a 33. A biopsy was then finally done which found cancer in all six of the samples.

Testing eventually found that the man had cancer metastasis to the lymph nodes, the liver and bone. Even with hormone therapy and radiation therapy the man died close to eighteen months subsequent to his diagnosis. The law firm that represented his family recorded that the case settled for $1.0 Million.