Case Study: Metastatic Lung Cancer

Confidential Settlement

The decedent presented to a local hospital on Dec. 23 with complaints of shoulder and neck pain following a motor vehicle collision. X-rays of her neck and shoulder were performed and were read as normal by the emergency room physician.

The following day, the decedent's shoulder films were reviewed by the radiologist who reported an apparent emerging lung nodule in the left upper lobe. The radiologist further reported, "Initial evaluation should include full AP and lateral chest films."

A copy of the radiology report was sent to the decedent's primary care physician, who saw her two weeks later but failed to order chest X-rays or any other diagnostic studies. The decedent returned to her primary care physician on six separate occasions over the course of several months after the initial finding and recommendation were made. No diagnostic studies were ever performed.

The decedent reported to the hospital the following Oct. 17, with complaints of severe pain. She was diagnosed with metastatic lung cancer and died a week later.

The case was mediated approximately one week before trial.

The defendant primary care physician was prepared to argue at trial that the failure to perform diagnostic studies as called for in the radiology report from Dec. 23, was a system failure within the medical facility; that the report was not brought to his attention and initialed before being charted, as was his standard practice; and that there was no evidence to indicate when the report was received.

The defendant's experts were expected to argue at trial that the nodule seen in the December X-ray was a metastasis; that the primary lung lesion was not visible on the shoulder film; and that the decedent was suffering from small-cell cancer with a minimal likelihood of success regardless of treatment.

The plaintiff's expert was prepared to argue that the decedent's clinical course, including survival without treatment for nearly two years after the December finding was made, was not consistent with small-cell cancer and that she would have had an excellent chance of recovery had further diagnostic studies been performed at the time of the initial finding.

The plaintiff agreed to amend the complaint so as to name the medical practice as the sole defendant and reached a settlement agreement after a half-day of mediation.

The outcome of every case is dependent upon the specific facts, circumstances and applicable law in that particular case.  Results in other cases are not a guaranty or indication that a similar result is likely in any other case.