Patient Suffers Delayed Diagnosis of Cancer Due to Mismanagement of Ultrasound Results

This case involves a woman who allegedly suffered a delayed diagnosis of treatable cancer due to a failure to follow up on suspicious imaging studies. The woman initially presented to her primary care physician with complaints of abdominal pain, cramping, and constipation. The doctor ordered an ultrasound, which the patient had done a few days after her initial appointment. The report from the ultrasound indicated the presence of a suspicious finding on the patient’s small intestine. The report recommended that the patient undergo additional testing, however this was never done, despite the fact that the patient was seen by her gynecologist just a few weeks later, who also was given the report on the patient’s ultrasound results. Two years later, the patient was diagnosed with stage 4 cancer.

Question(s) For Expert Witness

1. How often do you order abdominal and pelvic ultrasounds on patients in your practice?

2. What is the standard of care in terms of reading patient reports?

Expert Witness Response E-108499

I order ultrasounds to be done in my office or at abdominal radiology centers, and do so on a daily basis. All reports that come to an office should be reviewed and signed off. When a test isn't ordered by a subsequent treating physician, it should still be looked at by the subsequent physician, but the primary responsibility for following up on the test is borne by the ordering physician and the subsequent physician may think the ordering physician took care of it. Still, if the subsequent gynecologist sees the patient, her entire history should be reviewed and this problem should have been discovered. It fell below the standard of care for the doctor to have ignored the abnormal ultrasound, particularly as the patient was seen on multiple occasions by that doctor.