Urothelial Cancer Diagnosis Delay Claim Settles for $1 Million

2020 Medical Malpractice Case Report
By Attorney William J. Thompson
Newport County Superier Court
Newport, Rhode Island

Lawsuit claims urologist failed to undertake prompt testing of urothelial cancer and to monitor stricture

The plaintiff’s decedent died at the age of 73 from urothelial carcinoma.

The patient had a long and complicated urologic history. During the two years of alleged negligence, she had been diagnosed with recurrent urinary tract infections, hydroureteronephrosis, hydronephrosis, and nephrolithiasis. She had multiple urinalyses, urine cultures, blood testing, ultrasounds, KUBs, and CT scans of the abdomen and pelvis. She underwent numerous urologic procedures including cystoscopy, right retrograde pyelogram, ureteroscopy, and ureteral stent placement. She also had lithotripsy and passed stone fragments, but she continued to develop additional kidney stones.

The cause of the ureteral obstruction was unclear, but it was thought to be most likely due to recurrent stones or stricture. The patient was managed by regular replacement of her ureteral stent. The defendant urologist referred the patient to another specialist for consideration of reconstructive surgery. This surgery, ureteroureterostomy, in hindsight, would have somewhat incidentally removed the cancer. The patient, however, declined to undergo the surgery. She preferred to continue to manage her symptoms with stents.

During a stent replacement, the defendant urologist did a brush biopsy to check for cancerous cells. The biopsy did not show urothelial cancer. The diagnosis was retroperitoneal fibrosis. Still, the urologist discussed the possibility of ureteral lysis, but the patient still was not interested in proceeding with surgery.

Eventually, a CT scan found a mass that was biopsied and proved to be poorly-differentiated carcinoma consistent with urothelial carcinoma. The patient subsequently passed away as the result of her urothelial carcinoma.

The plaintiff claimed the defendant failed to undertake prompt testing to confirm or rule out urothelial carcinoma, and failed to order or perform cytology at regular intervals to monitor the stricture, among other things. The defendant denied liability, and contended he met the standard of care at all times.

The case was settled for the full policy limits of $1,000,000 after jury empanelment.

Lubin & Meyer attorneys Andrew C. Meyer Jr., William J. Thompson and Julie A. Gielowski represented the plaintiff in this lawsuit.

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