Misdiagnosis of Cancer in Kansas City
Our client, a 45-year-old Kansas City area man, was seen by his doctor with complaints of chest pain, shortness of breath and numbness in his arms. Because of these complaints, he was transported by ambulance to the emergency room of a local Kansas City hospital for examination and evaluation.
A CT scan was performed, and this was reported to show a large mass in the right chest. The emergency room physician provided a probable diagnosis of lung cancer and recommended further evaluation by way of a biopsy.
The biopsy was taken shortly thereafter, and the biopsy materials were provided to the hospital’s pathology department for analysis. Following review of the biopsy material, a pathologist provided a diagnosis of Lymphoblastic Lymphoma. No indication was made in this report that the tissue received from the biopsy was insufficient for purposes of making a definitive diagnosis, nor was any differential diagnosis made by the pathologist.
Lymphoblastic lymphoma is a very aggressive and lethal form of cancer that is typically rare in adults. It often attacks the central nervous system, and a particularly strong chemotherapy protocol is usually recommended to treat this cancer.
As a result of the diagnosis of Lymphoblastic Lymphoma, our client was referred to an oncologist for further evaluation and treatment. That doctor initiated chemotherapy and, following the initial course of treatment, recommended consultation and evaluation regarding a bone marrow transplant by a specialist in St. Louis.
Shortly before the evaluation in St. Louis, another CT scan of the chest was performed and this was read as negative for the presence of a mass.
In St. Louis, the specialist had our client’s biopsy slides reviewed and the reviewing pathologist indicated that the biopsy was consistent with cancer but that due to the limited material, he could not exclude the possibility that the mass could be a Thymoma, a non-cancerous tumor of the Thymus gland. On this basis, the specialist indicated that as the chemotherapy seemed to have been successful, re-biopsy was recommended if the mass was shown to have recurred on future radiology studies.
In spite of the initial pathology questions and our client’s unusual overall positive clinical picture, our client’s oncologist maintained a diagnosis of lymphoblastic lymphoma and proceeded with additional chemotherapy.
During the course of the additional arduous chemotherapy treatments, our client suffered several complications and was hospitalized on more than one occasion. Additional radiology studies were taken that indicated that contrary to the report of the earlier CT scan, the tumor was in fact still there and growing. Unfortunately, these radiological findings were not appreciated by our client’s oncologist and the chemotherapy treatments were continued.
Several months later, our client was living in Sedalia, Missouri and developed an infection. His oncology care was transferred to the Ellis Fischel Cancer Center in Columbia, Missouri as Columbia was closer to Sedalia. Because of his history, it was felt that our client was having a relapse and was sent back to St. Louis for further evaluation regarding a possible bone marrow transplant.
As previously recommended, with what appeared to be a recurrence of the cancerous tumor, the specialist recommended a re-biopsy of the mass. This interestingly resulted in a diagnosis of a thymoma, a non-cancerous tumor of the Thymus gland.
Following biopsy, surgery was performed to remove the tumor. Unfortunately, the tumor was not completely resectable and our client had to undergo follow up care consisting of a combination of radiation and chemotherapy.
As a result of this situation, we were asked to review the matter for purposes of pursuing a potential medical malpractice claim. Following review, we were able to determine that the initial pathologist was negligent in rendering a definitive diagnosis of lymphoblastic lymphoma. Primary factors relied upon focused on the fact that lymphoblastic lymphoma is not common in adults; that thymoma is the most common type of tumor in the anterior mediastinum and that a definitive diagnosis should not be made with limited biopsy material.
Our medical review further indicated that the treating oncologist had been negligent in failing to review multiple radiology studies that showed the continued presence of a tumor mass, indicating that re-biopsy should take place. Had this taken place at an earlier time, our client would have avoided the very unpleasant chemotherapy prescribed and might have been able to have the tumor fully removed at an earlier time without the need for additional chemo and radiation therapy. Most importantly, our client would not have had to deal with the inaccurate diagnosis of a very aggressive and lethal form of cancer.
Attempts to resolve the matter short of suit were rebuffed. Suit was then filed, and the case was litigated through discovery. Mediation was required by the court and following a day of intense negotiation, this misdiagnosis of cancer case was able to be resolved favorably by the lawyers on behalf of our client.