Lung Cancer Delay: $2 Million Settlement
Lung cancer goes undiagnosed due to lack of follow up on chest x-ray with abnormal finding
2020 Medical Malpractice Case Report
By Attorney William J. Thompson
Suffolk Superior Court, Boston, Massachusetts
The plaintiff, a 1-2 pack per day smoker for 30 years, alleged a delay in diagnosis and treatment of her lung cancer.
On 4/30/09, the plaintiff was seen in an Emergency Department for persistent abdominal and chest pain following a recent diagnosis of costochondritis and. She was evaluated in the Emergency Department by a resident and an attending physician, who ordered a chest x-ray to evaluate the plaintiff’s chest pain, and to assess for pneumonia, infiltrate, pulmonary edema, or congestive heart failure.
The chest x-ray was reviewed by a radiologist who noted an indeterminate new nodular opacity projecting over the left lower chest measuring approximately 7 mm and recommended a repeat chest radiograph or chest CT for further evaluation of the pulmonary nodule.
When discharged from the ED, the chest x-ray was first reported as normal. Later the ED doctor added an addendum to the discharge summary indicating that there was a nodule on the chest x-ray which was likely just an x-ray artifact, but should be followed up with a repeat x-ray or CT.
It was disputed whether the doctor told the plaintiff of the finding.
Chest x-ray never acted on
The plaintiff was seen by her PCP for sick visits over the next few years, but the chest x-ray results were not discussed at any of these visits, and no repeat chest x-ray or CT was done.
Lung cancer diagnosed, now stage 4
On 3/26/13, the plaintiff was seen for a persistent cough, shortness of breath, and dyspnea upon exertion. A chest x-ray showed a 4 cm left lower lobe mass at the site of the previous left lower lobe nodule. This led to a diagnosis of stage 4 lung cancer with metastases to the brain, lung, and lymph nodes.
The plaintiff began palliative radiation therapy and chemotherapy in May, 2013. As of the time of settlement in 2020, the plaintiff’s lung cancer was stable and she was not undergoing any treatment. She continued to work and live independently.
Lawsuit claims communication breakdown
The plaintiff claimed the defendants should have communicated better regarding the need for possible follow up with a chest CT. The defendants contended there was no specific reason to get a chest CT, and that the plaintiff was aware of the finding and never asked her doctors about any follow up imaging.
The case settled prior to trial for $2,000,000.
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