subject: PCP And Urologist Miss Man's Prostate Cancer For Five Years [print this page] Prostate cancer is a frightening disease. Even though not 100% accurate there are diagnostic tests that help doctors to figure out when the cancer is present in a patient. Yet because of the prospect of false negatives (a negative test outcome even though the patient in reality has cancer) doctors have to follow up and redo tests as appropriate when patient symptoms and screening tests keep showing the possibility of cancer. Not doing so may reslt in a malpractice claim.
In one reported case a patient told his primary care doctor that he was experiencing urinary frequency and burning. The physician commenced him on antibiotics and refered the man to a urologist. The urologist conducted a cystoscopy which revealed that the individual had an enlarged prostate. The urologist also did a PSA blood test which registered a 16.3 (a level higher than a 4.0 is normally considered to be abnormal). As a result the urologist performed a biopsy 2 months later. The biopsy was interpreted by a pathologist as benign.
The following year the individual returned to the urologist. This time the PSA was a 2.9 (generally considered to be normal). The urologist diagnosed the patient with BPH (a benign enlargement of the prostate). Three months later the patient saw the primary care physician with symptoms of fever and nocturia (having to urinate over the night). The physician put him on a second round of antibiotics. A follow up urine culture registered negative. The primary care physician thus referred the patient to the urologist. The urologist took a PSA test which registered a 6.4 (again, high).
A biopsy analyzes parts of the prostate. So, it is possible for a biopsy to miss the cancer. At this point, the urologist decided to depend on the preceding year's biopsy and to not do an additional one as a follow up. Instead, the urologist failed to follow up on the male's symptoms and high PSA. A year later the man returned to his primary care physician. His symptoms continued to include nocturia. On physical examination the doctor noted that the patient had a highly enlarged prostate. However, the doctor did not do another a PSA or re-refer the patient to a urologist. Routine blood testing four months afterwards showed that the male patient's PSA was at 7.4 Neither physician did anything to follow up.
The subsequent year the primary care physician noted that the PSA level was 9.8 Again, no follow up or referral to a urologist. Yet one more year and the man continues to have problems with nocturia. This time the PSA was 9.7 No follow up and no referral. On the fifth yea following the person's first reports of urinary problems the primary care physician once more recorded a substantially enlarged prostate gland and a PSA that had now risen to 31. The physician finally refered the patient back to the urologist.
The urologist verified that the patient's prostate was enlarged and put the man a two week program of antibiotics to be followed by an additional PSA blood test. After the PSA test was done 2 weeks later it registered a 33. A biopsy followed which found cancer every sample taken.
Testing afterwards uncovered that the patient had prostate cancer which had spread to the lymph nodes, the liver and bone. Regardless of a course of both hormone therapy and radiation therapy the patient passed away approximately 18 months subsequent to his diagnosis. The law firm that handled this matter documented that the case settled for $1,000,000.
PCP And Urologist Miss Man's Prostate Cancer For Five Years
By: J. Hernandez
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