Lack of further testing blamed for missed cancer

Orange County (NY) Supreme Court—After a routine examination in March 1998 showed an abnormal Pap result, a woman underwent a number of tests, including a CA-125, transabdominal and transvaginal ultrasound tests with color Doppler flow studies, endocervical curettage, and an endometrial biopsy to rule out endocervical cancer. The test results were normal, and a follow-up Pap in August 1998 also was normal. However, in January 1999, the patient was diagnosed with advanced-stage ovarian cancer. At that time, she had an abdominal hysterectomy followed by chemotherapy.

In suing, the woman claimed that because she had a family history of breast and ovarian cancer, the physician also should have performed a laparoscopy and referred her to a gynecologic oncologist.

The physician argued that since the laboratory and imaging results were all normal, there was no indication to perform additional testing. She believed the abnormal Pap was probably a false-positive reading. Lastly, she maintained that the ovarian cancer was not present during the tests performed in 1998 and that it most likely developed 2 to 4 months prior to diagnosis.

The jury returned a defense verdict.

The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts. While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.