Prostate Cancer Diagnosis Delay: $1.5 Million Settlement
Medical Malpractice Settlement Report, 2021
By Adam R. Satin, Medical Malpractice Attorney
Medical malpractice lawsuit claims urologist's delay in diagnosis of Gleason 9 prostate cancer leads to advanced disease
This medical malpractice claim involved a delay in diagnosis of prostate cancer against the plaintiff’s Primary Care Physician (PCP) and Urologist. Prostate specific antigen (PSA) screening was performed on the patient on an annual basis and remained within the normal range until late 2011.
In December of 2011, the patient’s PSA rose to 4.15 and the PCP opted to repeat the test in a short duration of follow up. However, follow up PSA results remained elevated, but the PCP failed to refer the patient to urology for almost 8 months.
The patient saw the urologist who noted the history of PSA elevations and diagnosed him with an enlarged prostate. The urologist recommended follow up PSA to be done in 6 months. In that time, however, the plaintiff was diagnosed with idiopathic thrombocytopenic purpura (“ITP”), which is a disease that predisposes patients to bleeding, as well as bladder cancer. The follow up PSA testing was eventually completed and was further elevated at 6.6, but no biopsy was ordered at that time. However, when repeat PSA was undertaken, it remained elevated at 6.0, but it was less than the prior value, which the defendants claimed was inconsistent with prostate cancer. Thus, the continued to watch and wait.
The patient’s PSA was taken on multiple subsequent occasions and continued to increase further. However, the urologist claimed that the patient was recommended to have a biopsy but declined it due to his risk of bleeding from his ITP and his risk of infection (because he had had an unrelated and difficult experience with sepsis). The urologist relied on references in the medical record to support this positions. However, the plaintiff denied that he had declined a biopsy and claimed that references in the record on the matter were vaguely written (which would not be the case if the patient had truly declined such an important diagnostic procedure) and claimed that the vague references in the record merely reflected the patient’s acquiescence to the urologist’s recommendation that they should continue with watchful waiting instead of ordering biopsy.
Unfortunately, the PSA values continued to rise and, eventually, an MRI was ordered by the urologist, which strongly suggested prostate cancer. Subsequent biopsy confirmed advanced Gleason 9 prostate cancer.
The defendants claimed that the biology of this tumor made it incurable from its inception, but plaintiff’s counsel pointed to prior success at trial in other cases despite the identical defense.
The case was settled for $1,500,000.
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