Leading Oncologist Opines on Standard of Care in Chemotherapy Administration

Case Overview

This case involves an elderly male patient in Florida with a history of cancer, as well as a chronic respiratory condition, who reported to the hospital for breathing treatment. Following this treatment, the patient was made aware that his WBC count was high, which was attributed to his previous cancer diagnosis. He had stated in the past, and reiterated on this visit, that he did not want to be administered chemotherapy. Despite these instructions, he was admitted to the hospital and chemotherapy using Taxotere was initiated. Soon after the initial dose, he experienced acute respiratory failure, shock, electrolyte abnormalities, as well as cardiovascular and renal problems. He was then transferred to the ICU, where, despite his critical condition, chemotherapy was continued nightly for five days before passing away. The ultimate cause of death were complications related to tumor lysis syndrome, which was brought on by the administration of chemotherapy.

Questions to the Oncology expert and their responses

Do you routinely treat patients similar to the one described in the case?

I do routinely treat patients with chronic leukemia and have for over 20 years. Depending on the type of chronic leukemia, prior therapies, and status of the disease (e.g., later stage CLL or accelerated/blast phase CML), yes such patients can develop tumor lysis and complications thereof.

Do you believe there may have been a deviation in the standard of care that contributed to this patient's poor outcome?

From what is described, and certainly if the chemotherapy was against the expressed wishes of the patient, it is possible that there was a deviation in the standard of care.

About the expert

This highly qualified expert is board certified in Internal Medicine and Medical Oncology. He has specialized in treating blood disorders for over 20 years. He earned his BA and MD from Indiana University, where he remained for his residency in Internal Medicine. He completed a fellowship in Hematology and Oncology at the University of Chicago. He he is a member of several prestigious societies in his field, including the American Society of Hematology and American Society of Clinical Oncology. He is the Chair of the Institutional Review Board and Professor of Hematology & Oncology at a Top Tier Medical University. He maintains a busy clinical practice, with over 20 years experience in treating blood disorders. This expert is well published with over 60 peer reviewed journal publications, book chapters and abstracts. He is also actively involved in the education of medical students, residents and fellows.

E-000979

Specialties:

Oncology