This case involves an elderly female patient who presented to her primary care physician with complaints of occasional rectal bleeding. According to the physician, the patient declined a digital rectal exam, despite the fact that one was allegedly offered. The plaintiff claimed that the benefits of the test were never discussed, and a colonoscopy was not offered as a next step in her treatment. The patient continued to complain of similar symptoms in subsequent visits, and had stated that the symptoms were becoming progressively worse. Eventually, the patient underwent a colonoscopy that discovered a cancerous growth. It was claimed that the cancer would of been diagnosed earlier had proper treatment been rendered.
Question(s) For Expert Witness
1. What is the protocol for educating patients with rectal bleeding who decline DREs?
2. What is the standard follow-up for a patient with this presentation?
Expert Witness Response E-108396
Unless contraindicated, a digital rectal exam is always recommended as part of the examination for rectal bleeding. With any intervention or examination, patients should be informed of the purpose of the examination and the risks of not doing an examination if declined. In the case of a declined DRE for rectal bleeding, patients should be informed of the potential for missed cancer, difficulties adequately diagnosing a persons symptoms and delayed diagnosis. Typically a person with rectal bleeding of unknown etiology on history/examination should undergo timely investigations with colonoscopy.
About the author
Joseph O'Neill
Joe has extensive experience in online journalism and technical writing across a range of legal topics, including personal injury, meidcal malpractice, mass torts, consumer litigation, commercial litigation, and more. Joe spent close to six years working at Expert Institute, finishing up his role here as Director of Marketing. He has considerable knowledge across an array of legal topics pertaining to expert witnesses. Currently, Joe servces as Owner and Demand Generation Consultant at LightSail Consulting.