This case takes place in Alabama and involves a male patient who underwent a minor surgical procedure that concluded without complication, however a post-operative pathology report revealed the presence of spindle cell carcinoma. In spite of the report’s findings, the patient claims that he was never notified about the presence of cancer in his body or instructed to seek treatment. Some time later, the surgeon who performed the procedure signed the surgical notes, which included the pathology report’s findings, however he again failed to notify the patient of his cancer. The patient was never notified of his diagnosis despite numerous subsequent visits to same hospital for various complaints. Eventually, the cancer metastasized, causing severe pain and significantly decreasing the odds of successful treatment. The plaintiff presented to the ER in response to his pain, where he was prescribed pain killers and was sent home. Eventually, the hospital re-discovered the cancer and informed the patient of his initial diagnosis, by which time he had developed numerous masses throughout his body, making successful treatment very unlikely.
Expert Witness Response E-008023
This case is of particular interest to me, not only as a prior oncology hospitalist, but as a Director of Quality and Safety. Effectively managing test results that return after an episode of care or discharge from the hospital is something I’ve worked extensively on. I worked as an oncology hospitalist and directed our Oncology hospitalist program from July 2009 to June 2012. I continue to work as a hospitalist and direct inpatient quality and safety activities for the Division of Hospital Medicine and our inpatient Medicine service. There is a responsibility to review the results of tests that have been ordered and inform patients. The generally accepted responsible person is the provider that ordered the test. In many cases, this is a surgeon who ordered pathology, but sometimes the surgeon acts on the request of another party like a primary care provider or ENT. The details of referral to surgery would be important in this case. It is left up to an individual health system as to standard procedure. This has been an area of rapid improvement and standardization over the last 7 years. Many articles have been published that have now more firmly established the standard of care, so the challenge would be in determining what the standard of care was at the time of the incident.
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