The most common cause of cancer malpractice litigation is failure to diagnose cancer promptly. Typically the sources of conflict are:
Failure to act on a symptom. For breast cancer this is typically a lump. For lung cancer it is a cough or chest pain. For colon cancer it is a change in bowel habits or frank bleeding.
Failure to act on an abnormal x-ray or laboratory value. Depending on how a physician’s office works, reports can get into charts without the physician’s awareness. Sometimes he sees the report but in the crush of business or for whatever reason fails to act on it. Examples include:
- Abnormal Chest X-ray. Often there will be a recommendation to get a CT scan or repeat the film in six to eight weeks and the advice will simply be ignored.
- Abnormal PSA. Physicians will comply with what they perceive as best practice patterns, order a PSA and then not do anything about an abnormal result. Sometimes the PSA is still normal but substantially higher than the previous one. This is a cause for action, but many doctors do not know this even though they should.
- Anemia, especially iron deficiency anemia. Iron deficiency in a man is never normal, nor is it for a post-menopausal woman. Pre-menopausal women can be iron deficient from heavy menses but if the woman is over forty the colon as a source of bleeding (polyp or cancer) should not be ignored.
- Abnormal PAP smear. Atypical or dysplastic PAP smear reports sometimes make it into charts without any action being taken.