Physician Fails to Treat Nerve Sheath Tumor After Detection

    Neurology Expert WitnessThis case involves a patient who presented to defendant with an extensive history of neurofibromas and complaints of a cough. The doctor scheduled a CT scan to explore for changes in her neurofibromas. The patient had a CT scan performed, however there was no indication that the CT scan was reviewed. The patient was not seen again until some months after her last CT scan, when the treating physician had been ordering CT scans at a minimum of every six months based. Eventually, a CT scan was performed which showed a large mass with a mass effect on the trachea. The physician indicated in the medical records that he was aware of the mass. Some months later, as a result of complications from the inoperable nature of the mass due to the delay in treatment, the patient died. It is alleged the defendants failed to properly monitor patient’s known medical condition for which he was under their care by failing to order appropriate follow-up after the mass was discovered.

    Question(s) For Expert Witness

    • 1. Do you have extensive experience treating patients with neurofibromas?
    • 2. Are you familiar with the proper way to monitor patients with neurofibromas?

    Expert Witness Response E-004713

    I have seen and treated patients with neurofibromas and neurofibromatosis. Generally, yearly CT or other imaging is not recommended. However, if there are new symptoms, as in this patient, it is required to image the area related to the symptoms. While these are often benign lesions, they cause difficulties due to mass effect and airway compression and debulking surgery can be lifesaving. In this case, the MD who initially ordered the CT chest is negligent for not following up on the results of the initial CT chest and for not maintaining proper surveillance every 6 months fro growth. This is especially important given the new symptom of intermittent cough that prompted the initial CT scan.

    Expert Bio

    This Dallas area neurologist earned both his MD and PhD from the Baylor College of Medicine. After his residency at UCSF, he completed a prestigious fellowship program at the National Institutes of Health. An active member of the American Academy of Neurology and the Society for Neuroscience, he is widely published in his field and is frequently invited to present his work at national conferences. In addition to his clinical responsibilities, he currently serves an as associate professor of Neurology at one of the most prominent medical institutions in Texas.

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