Patient Dies From Undetected Cancer

Joseph O'Neill

Written by
— Updated on October 5, 2017

Cancer Expert WitnessThis thoracic radiology case involves a patient who presented to a hospital in Idaho with chest pains, after which she was referred to a cardiology clinic. At the time of the cardiology visit, the patient continued to complain of chest pains associated with weakness, however the doctor did not discover an explanation for those pains or order any follow-up tests. The patient was later diagnosed with aggressive cancer, which eventually killed her. As a result of her cancer being undetected, the patient lost a chance of survival. It is claimed that with more assessment, including radiology studies, chest x-rays and a CT of her chest, the patient would have had a better outcome.

Question(s) For Expert Witness

  • 1. Do you have extensive experience treating patients with severe chest pains?
  • 2. What steps should be taken after a patient complains of left sided chest pains?
  • 3. What kind of complications can arise by not performing a chest x-ray or CT scan of the thorax?

Expert Witness Response E-000988

I have extensive experience evaluating chest pain.  Left-sided chest pain as described above raises the immediate concern about myocardial ischemia.  Pleural chest pain from a metastatic lung cancer is a possibility but lower on the list.  Based on the case information, my question about this case is not whether the patient should have had a chest x-ray or CT at the time of the cardiologist visit, but what happened subsequently. Did the chest pain resolve in the days/weeks after?  The longitudinal course of the pain symptoms is most critical.  If the pain persisted, then clearly someone should have investigated further, which may have resulted in earlier diagnosis.

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