Mrs C underwent a biopsy, which showed invasive adenocarcinoma, and a PET scan confirmed that it was stage IV disease. Mrs C’s prognosis was extremely poor due to the late stage at which the cancer was identified.
Before long, Mrs C developed brain metastases and died soon thereafter, leaving a husband and 2 college-aged children.
The widower contacted a plaintiff’s attorney and asked whether they might have a case against the NP and her practice.
“My wife went for an X-ray almost a year and a half earlier and they never told her the results!” Mrs C’s widower exclaimed. “What if she had the cancer then and it could have been treated?”
The attorney subpoenaed the medical records, including the radiograph results and hired medical experts to review them. The experts told the attorney that the first X-ray had shown a mass, which had more than doubled in size by the time of the second X-ray.
According to the experts, the 16-month delay in diagnosing the cancer compromised Mrs C’s chances of survival, and the delay was directly attributable to Ms Q’s failure to follow up on an X-ray that she had ordered. With this information in hand, the attorney told the widower that they had a case, and he filed a malpractice lawsuit against Ms Q and the practice.
Ms Q met with the defense attorney provided by her malpractice insurance. This attorney also hired medical experts to review the records. The experts were critical of Ms Q’s treatment of the patient, specifically her failure to follow up on a test that she had ordered.
The experts were also critical of the practice’s failure to have a procedure in place to verify that reports that are ordered are received and reviewed by the clinician. Based on this, the attorney advised Ms Q to settle the case out of court. Ms Q and the practice settled prior to trial for an amount within their malpractice limits.
It should go without saying that if you order a test, you must review the results. Tests are ordered for a reason. Ignoring the results, or not bothering to look for them, negates the whole purpose for ordering them in the first place. Time is often of the essence with medical problems. Delays in getting and reviewing results can have a tremendously negative impact on a patient, as they did here.
If you order a test, put a mechanism in place to remember to check for the results, whether it is a note, a memo on your computer, or a reminder on your phone. A procedure should be instituted so that the office is aware of what results have come in and what results are expected to arrive, so that follow-up can occur if the results do not appear.
Mrs C’s options for treatment and chances of survival were significantly affected by the 16-month delay. Avoid this by ensuring that you follow up on every test ordered, and make sure that your practice has a policy not only to deal with results that arrive, but also to deal with those that do not.
Ms Latner, a former criminal defense attorney, is a freelance medical writer in Port Washington, N.Y.