Radiologist, PCP Miscommunication Creates Delay in Lung Cancer Diagnosis
$1.5 million medical malpractice settlement reached in failure to act on report of lung lesion and CT scan
2020 Medical Malpractice Case Report
By Attorney Krysia J. Syska
Worcester Superior Court
On 7/1/11, plaintiff’s decedent underwent a chest CT scan for a sternal wire complication post CABG surgery. The study was interpreted by the defendant and did not report the presence of a 5 mm nodule in the lung requiring follow up in 6-12 months.
In January 2013, the defendant PCP ordered a chest x-ray for the decedent due to a cough of 2 weeks. The decedent had a smoking history of 1.5 packs/day for greater than 40 years. The chest film dated 1/10/13 demonstrated a possible nodular density in the left mid-lung. The radiologist suggested follow up CT scan.
A chest CT dated 4/5/13 interpreted by the defendant revealed a 1.78 cm nodule in the left upper lobe and was reported as suspicious for malignancy. The defendant recommended follow up imaging and /or biopsy, yet he failed to directly communicate these serious findings to the PCP to ensure follow up testing was pursued. Plaintiff’s expert radiologist opined that this mass was in the same location as the 5 mm nodule seen in 2011 and he was prepared to testify the malignancy grew from this nodule.
Despite her office’s receipt of the 4/5/13 CT scan report, the defendant PCP did not inform the decedent of these findings and inexplicably did not order any follow up testing. The PCP testified that she did not receive the report and was therefore unaware of the findings despite seeing the decedent in her office for numerous appointments over the next 18 months.
On 1/26/15, a chest x-ray was obtained due to a dry cough. The radiologist compared the present study to the April 2013 CT scan and noted that there was significant enlargement of the previously seen left upper lobe nodule. The mass had increased in size from 1.78 cm to 7.5 cm. Further testing confirmed malignancy with spread to the lymph nodes and beyond. Unfortunately, the decedent passed away only 2 months after diagnosis due to complications related to his advanced lung cancer. He was 68 years old.
The defendants argued there was no duty to speak directly with the PCP as the important information was contained within the report and the duty was on the PCP to obtain the follow up testing. The PCP argued she never received the information and would have hoped for direct communication.
The parties agreed to settle the claim prior to trial for $1,500,000.
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