Delay in Diagnosis of Thyroid Cancer: $1.75 Million Malpractice Settlement
2012 Medical Malpractice Trial Report
Repeated failures to test enlarged thyroid for cancer and allegedly spoilated primary care records leads to settlement
This medical malpractice action involved the failure of a primary care physician (PCP) to rule out cancer as the cause of the decedent’s enlarged thyroid. The decedent had been seen by the defendant for more than two years with an enlarged thyroid gland. A substantial portion of the defendant’s medical records were missing as of the time of the litigation and the plaintiff was prepared to argue that the records were intentionally or negligently spoliated by the defendant or her corporate medical group, which was a co-defendant.
The plaintiff saw the defendant between 2002 and 2005. At all visits, he had an enlarged thyroid that the defendant assumed was a benign goiter. She did not refer the decedent for an ultrasound, nor did she recommend that he have one. As the thyroid became more enlarged and began compressing his throat, the decedent became more concerned and went to go see a specialist, who referred him for an ultrasound. The ultrasound showed a very large thyroid. The right lobe measured 8.9 x 5.7 x 4.0 cm with a 3.8 x 3.0 cm nodule at the upper pole. The left lobe measured 6.5 x 1.8 x 1.5 cm with a 1.3 x 1.0 x 0.8 cm nodule at the mid to lower pole. Thea plaintiff underwent a total thyroidectomy and pathology revealed oncocytic (Hurthle cell) carcinoma, measuring 4.5 cm which arose in the setting of a multinodular thyroid. Lymphovascular space invasion was noted. Based upon the pathology findings, the plaintiff was diagnosed with stage pT3, NX, MX Hurthle cell carcinoma.
The defendant was prepared to argue that a volume of the plaintiff’s medical records was missing, but that she had no idea why. She claimed that an ultrasound was not indicated because the characteristics of the goiter were not concerning for malignancy. The defense was further prepared to argue that the delay had no impact on the plaintiff’s outcome because the cancer did not respond to radioactive iodine treatments and that its resistance to treatment indicated a poor prognosis even if the cancer had been diagnosed sooner. Plaintiff’s counsel was prepared to argue that there was, at a minimum, negligent spoliation of the record by the doctor or her group practice and that the plaintiff lived for several years despite the claimed resistance to radioactive iodine such that the delay clearly impacted his even further survival had it been treated in time.
Massachusetts: Norfolk Superior Court
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