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Vigilant Woman Wins Settlement for Delay in Diagnosis of Colorectal Cancer

A 61-year-old-woman was diagnosed with metastatic colorectal cancer after both her doctor and gynecologist failed to conduct colorectal screening.

This woman felt especially betrayed by her doctors as she was very active in seeking preventive health care and would have undergone appropriate screening if she had been advised to do so.

She had been so active in engaging in preventative medicine that during the 15 years with her previous gynecologist, she underwent a barium enema for a complaint of a “pulling sensation” in her right lower quadrant. The test was normal.

She later had a guaiac positive stool, and a GI evaluation was recommended, but no mention of referral or follow up with GI was documented.

Before her gynecologist retired, the woman again complained of “a pulling sensation” in her right lower quadrant. A rectal/vaginal examination was normal.

The woman first visited her new gynecologist at age 55, and records were provided when the care was transferred. The woman selected a primary physician at the same time and began a series of annual exams with each doctor.

Two years later, the woman first complained to her new gynecologist of “a pulling sensation for past two years.” The woman said that her previous gynecologist thought it was a GI issue.

Her new gynecologist testified that she thought the woman would follow up with her doctor about it, though there is no record of either communication with the doctor or a referral for the issue.

The woman, with no family history of colon cancer, called her doctor with complaints of bright red rectal bleeding and discomfort. She was referred to a gastroenterologist and diagnosed with colon cancer.

The patient sued both the gynecologist and her doctor, alleging failure to appropriately screen for and diagnose colon cancer. This case was settled for $1 million and was successful due to these factors:

The woman did not receive the standard of care for colorectal screening. This was her doctor’s fault, not that of her OB/GYN. Colorectal screening for asymptomatic patients over age 50 includes annual rectal exams and stool blood tests followed by a flexible sigmoidoscopy every five years. The woman’s doctor failed to order those tests.

Relying on the woman to share recommendation about GI work up contributed to a delay in diagnosis. Patients who appear diligent and competent may still fail to follow through. It is the doctor’s responsibility to order the referral.

Lack of communication between providers. Specialists who are presented with troublesome symptoms outside their area of expertise should notify a patient’s personal physician about the patient’s symptoms, which makes for a proper handing off of the issue to the appropriate provider. The woman’s OB/GYN should have notified her doctor of her symptoms.

Lack of review of a new patient’s prior records for cancer screening. Doctors should review symptoms and confirm previous screenings. Failure to offer screening and/or appropriate follow-up delays diagnosis of problems. Doctors should document personal and family history, review of systems, and confirmation that age and gender-appropriate colorectal screening was offered and completed.

No documentation by the doctor that previous GI tests had been reviewed. Following discussion of a previous work-up, a doctor must attempt to obtain the test results and review them. It’s an important element of patient assessment that must be documented.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

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