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ARTICLE ID 187082

$________ – MEDICAL MALPRACTICE – ONCOLOGY – FAILURE TO DIAGNOSE MEDULIARY THYROID CANCER – PROGRESSION FROM STAGE II, CARRYING 85-90% OF CURE, TO STAGE IV, ULTIMATELY INVOLVING METASTASIS TO LUNGS.

Suffolk County, NY

The plaintiff, 30 at the ________ deviations, contended that the defendant endocrinologist, who was referred by the co-defendant internist when the internist detected an enlarged thyroid during a routine exam, negligently failed to conduct a needle biopsy, which would have resulted in the diagnosis of Stage II medullary thyroid cancer and prompted the removal of the thyroid gland, providing an 85-90% cure rate. The plaintiff contended that by the time the cancer was diagnosed 13 months later, it had progressed to Stage IV that ultimately involved the lungs.

The plaintiff visited the defendant internist for a routine exam and he noted an enlarged thyroid. The physician recorded that a fine needle biopsy was indicated. The internist ordered a sonogram that showed five 2-3 cm. masses. The internist referred the plaintiff to the defendant endocrinologist. The plaintiff, who was pregnant, was 12 weeks into term and the plaintiff contended that the defendant endocrinologist negligently attributed the enlargement to the pregnancy.

The plaintiff maintained that an enlargement of the thyroid because of pregnancy is virtually unheard of in North America because of iodine additives and contended that attributing the abnormal thyroid to the pregnancy was clearly improper. The plaintiff further pointed out that one portion of the thyroid was 14 times greater than the remainder and that the lack of uniformity in the enlargement was a further indication that a pathological process was occurring.

The defendant internist maintained that by referring the patient to an endocrinologist, he had fully discharged his duty. The internist’s records, taken at about the time of the plaintiff’s visit, reflected that a needle biopsy was indicated. The plaintiff contended that in view of the evidence that the internist had formulated a course of action and referred the patient to a specialist to have that course taken, the defendant internist should have followed-up with the endocrinologist, who saw the patient six days after the internist had taken this course of action.

The defendant endocrinologist contended that the plaintiff’s youthful age rendered her at low risk for thyroid cancer. The defendant also contended that medical science believed that multiple thyroid tumors were in most cases benign and that the risk of malignancy was greater in the case of a single tumor. The plaintiff countered that the standard of care had changed some years earlier and that more recent studies reflected that multiple growths could well be indicative of cancer and that the standard required adequate investigation.

The defendant endocrinologist further contended that the plaintiff did not keep an appointment for three months after he initially saw her and maintained that had the plaintiff kept the appointment, further evaluation at that time may well have led to a biopsy. The plaintiff countered that there was no reason because of the pregnancy to delay biopsy and surgical removal of the thyroid when the tumors were found to be malignant. The plaintiff also maintained that the ultrasound ordered by the internist reflected the absence of any indication that the cancer had spread beyond the thyroid.

The plaintiff maintained that when the patient visited the internist approximately 13 months after her first visit, the internist referred her to a non-party head and neck surgeon and that the cancer was then diagnosed. The plaintiff contended that it had metastasized to the lungs where approximately 30 small tumors were noted as of approximately six months after the diagnosis. The plaintiff maintained that the appropriate treatment, even if timely diagnosed, was the removal of the thyroid and had such surgery been performed at the earlier time, the plaintiff would have had an 85-90% chance of survival.

The plaintiff contended that the spread to Stage IV reduced her chances to approximately 10%. The plaintiff argued that the jury should consider that the pain and suffering attendant to a death from a lack of oxygen, infection or both is extensive. The plaintiff also maintained that the emotional devastation is all-the-greater because the physicians had the means to save her and failed to do so.

The plaintiff maintained that she has undergone three surgeries since the time of the diagnosis. The plaintiff maintained that although the cancer is slow growing, her prognosis remains grave. The proofs related that the plaintiff undergoes CT-scans twice per year to ascertain the extent of progression and the plaintiff contended that the anxiety is even greater around such times.

The defendants contended that irrespective of the sonogram from the time of with the first visit with the internist, which the plaintiff contended reflected the absence of any spread to the lymph nodes involvement, it was very likely that there was lymph node involvement at that time and that the cancer would have been at Stage III, carrying a 70% chance of survival. The defendant further denied that the plaintiff now has Stage IV cancer, contending that if the growths in the lungs were malignant, they would have grown much more rapidly. The plaintiff countered that the some 30 lung tumors were first noted approximately one month after the thyroid cancer was ultimately diagnosed by the non-party head and neck surgeon, that all of her treating physicians believed that the growths were cancerous and that irrespective of the slow growing nature, it was clear that the thyroid cancer had spread to the lungs.

The plaintiff has a husband and three sons, age 15, 12 and seven at trial.The jury found the defendant endocrinologist 69% negligent, and the internist 22% negligent. The jury also returned with a finding of 9% comparative negligence against the plaintiff, but that such negligence was not a substantial factor. The jury then awarded $________.

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