Primary Care Doctor Causes Delayed Cancer Diagnosis

Oncology Expert WitnessThis case takes place in Kentucky and involves a delay in the diagnosis of cancer caused by alleged negligence on the part of a primary care physician. The Defendant in this case was a primary care provider for a young boy who visited the Defendant’s office for multiple, repeated illnesses of an unknown etiology over the course of several months. The patient presented to the Defendant’s office with a range of bacterial infections in multiple areas of his body, and had been given multiple antibiotics, including Avelox, as treatment by the Defendant on multiple occasions. While the Defendant physician noted several abnormalities through physical examinations of the patient, he never sought additional laboratory testing, nor did he refer the patient to a specialist of any kind for further evaluation. Eventually, the patient began to display more worrying signs of illness, such as respiratory distress, problems balancing and walking, and general lethargy, however the doctor did not investigate possible causes of disease any further. Eventually, the patient was taken to the hospital after collapsing while at home. The patient was kept in the hospital for several weeks, where it was discovered that he was suffering from a rare and advanced form of leukemia. Eventually, the patient suffered multiple organ failure and died in the hospital. It was alleged that the patient’s chances for a favorable outcome were significantly diminished by the delay in diagnosis he experienced.

Question(s) For Expert Witness

  • 1. Do you routinely treat patients similar to the one described in the case?
  • 2. Do you believe this patient may have had a better outcome if the care rendered had been different?

Expert Witness Response E-009560

I routinely care for patients with  leukemia as faculty in the leukemia and lymphoma program at a major university medical center’s pediatric hematology-oncology division. I see patients in various stages of disease progression, from initial diagnosis to end of life care. From the case scenario above, it seems that the patient had leukemia for an extended period of time, and if diagnosed at an earlier time point it may have been caught while it was still standard risk leukemia – which has over a 90% five-year survival. Even if he had been diagnosed only a few weeks or months before his final presentation at the hospital, and he was deemed a high-risk leukemia patient, he likely would have had an 80% five-year overall survival. Of course various features such as cytogenetics and other features can change the above statistics, but for most cases the above numbers hold true. I am qualified as an expert reviewer of this case as I my area of expertise is pediatric hematology-oncology. I am an assistant professor at a major university medical center where I spend approximately 80% of my time caring for patients similar to the case above, and 20% of my time is spent in clinical research and administration as well. I am a member of the Children’s Oncology Group, where I help to treat pediatric patients with the most up-to-date clinical protocols. I also focus my expertise in pediatric hematology-oncology in hematological malignancies such as leukemia as well as benign hematology and hematopoietic stem cell transplantation.

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