Medical Malpractice regarding lung cancer?

[lost in ak]

What is the name of your state? Alaska

About a year ago my mom started have hoarsness and a non productive cough she had been going to her doctor and her diagnosis was laryngitis and was given flonase nasal spray. The hoarsness never completely went away and about four months ago it got much worse. Her doctor continued to diagonse her with laryngitis. Two weeks ago my mom took it apon herself and decided to go to an ENT to find out why she was not getting any better. They did a scope and discovered her vocal cord was paralised. At that point they ran a CT scan and discovered a mass in her left upper lobe and mediastinal area. The mass was on a nerve causing paralysis of her vocal cord. They then did a bone scan and found a hot spot on her hip bone. They did a biopsy of the mass in her lung and her diagnosis is stage IV adenocarcinoma with a poor prognosis. Would this be considered medical malpractice? Should I attempt to hire an attorney? I understand doctors are very protected in the legal aspect but I feel if this doctor would have done some kind of test to see why she was hoarse, maybe we could have caught the cancer in an earlier stage.
Thank you

 

[rmet4nzkx]

You might take the case to a med-mal attorney for a review of the facts and see if there is merit in the case. Some cancers spread very quickly and by the time they are discovered may be too late, not knowing everything in her record it woiuld be impossible to determine cause here. Part will depend on your mother's general health and medial history and of course the big quesiton, was your mother a smoker or exposed to second hand smoke?

 

[lost in ak]

Yes my mother was a smoker for 29 years. she quit smoking three years ago after she had a mild stroke. I just feel she should not have had laryngitis for that long without any test to rule any other factors out. My mother knew the risks of smoking and I as well. I strongly feel if they would have done a simple chest x-ray a year ago she could have started treatment and maybe it would not have spread to her bone. But this is all new to me and I would hope this doctor will not diagnose another patient with laryngitis for that long and end up with the same reslults as we did.

Thank you for responding

 

[rmet4nzkx]

I'm sorry but you will have to have her records reviewed but the history of smoking will be difficult to overcome even if there was an Xray, at the time the symptoms presented they were treated, many people with smoking histories develop nervious coughs and environmental factors can still affect the patient. Hindsight is 20/20 but an Xray may not have been indicated at that time. Some women get a horse voice due to endocrine problems, many reasons that do not require Xray. Even if an Xray was performed 1 year ago, it may have still been too late, the cancer may have started elsewhere and spread to the lungs. The stroke may have been the result of smoking as well. Too many factors to determine cause or negligence here.

 

[Honey1955]

Take the case to an attorney where he can have it screened for merit. Remember you will need your Mother to consent for release of her records unless someone else has Power of Attorney.
Her history of smoking can be looked in two ways. 1. The smoking resulted in the cancer. 2. The physician, knowing that the patient had a 29 year history of smoking and now has longterm hoarseness (one symptom of cancer) failed to meet the standard of care by not further investigating the cause or at least refer her to the ENT.
Discuss it with your mother, take it to the attorney. The attorney will have every aspect reviewed and then give you his opinion.

 

[panzertanker]

OP, you state "The hoarsness never completely went away and about four months ago it got much worse. Her doctor continued to diagonse her with laryngitis."

How often did your mother go to the Doctor and receive the same diagnosis?

 

[lost in ak]

I am not sure, that is why I will get a copy of her records. But I know she is seen on a regular basis for her blood pressure meds. My mom also has email's from her doctors nurse regarding her hoarsness. That is how I feel my mother quit smoking the day after she had a stroke, her doctor was aware of her 29 years of smoking, her stroke, her High blood pressure, Hoarsness, Coughing and wheezing. I just feel with someone with this kind of medical problems a doctor would run more tests to make sure the hoarsness was not anything serious (like cancer). I do understand I must bring her medical records to an attorney. (The oncologist ordered a PET scan and they found more cancer in her thyroid, both sides of the lungs, her liver, and her hip bone.) This tells me it would have made a difference if she had started chemo a year ago. I know my mom she would have started treatment immediatly if she would have known. Now instead of hoping for a cure or a miracle we are figuring out power of attorney, living will, tying up loose ends. It's just not fair.

 

[rmet4nzkx]

This is a lot more information, but you still don't definitively answer the question about how ofter she went back to the doctor that thought it was allergy related, nor do you have her whole medical history available to you now. While this is all very frustrating and sad, A lot has happened to your mother in the last few years and your number one priority will be attending to her affairs and making her last days as comfortable as possible. I suggest that you consult at once with a probate attorney who can assist with that and arranging for what ever legal course seems appropriate.

Her current onocologist should have or request copies of all her records for you, make sure your mother gives them permission to speak with you and to release records. I know what you feel, but that may not be proveable medically or legally and the last thing your mother needs right now is stress about what she or her doctors should have done in the past. With as extensive as the spread is currently, Xrays or Chemo 1 year ago may not have made a difference other than adversley affect the quality of her life. Ask her Onocologist their opinion as to the original site of the cancer and if an Xray 1 year ago would have been indicated and or would chemo have made a difference. Have there been any biopsies? What were the findings?

Liver cancer is a silent but deadly cancer, so if it started there it is often too late by the time it is discovered. If it started in her thyroid, another place which could have caused horseness as I already mentioned, an Xray 1 year ago may have been clear. 1 year ago it may have been an allergy or hypersensitivity, masking the other medical conditions. Unofortunately, at this point you don't have enough information to prove a case of negligence or malpractice, but you may suspect one. See what her Onocologist thinks and keep us updated.

 

[ellencee]

I believe the numerous metastatic lesions indicate a cancer that presented in its final stages and no treatment would have changed the outcome. The treatment that would have been required would have been as deleterious to the body as the cancer and the outcome would have been the same, except that the patient would have been deathly ill every day for the past year.

Staging of the tumors or lesions will reveal the length of time the cancer has been present (but silent). The OP should look for reports that include staging, if any has been done.

EC

 

[Qfrank]

Adenocarcinoma of the lung

Adenocarcinoma of the lung is one of the most common types of lung cancer (35% of all primary lung malignancies).

It is also clearly linked to smoking.

The presenting symptom of hoarsness due to paraylsis of the recurrent laryngeal nerve indicates that the cancer was well on its way.

It is impossible to go back in time and determine if immediate identification and treatment of her cancer would have made a significant difference.

However it is well established in medical literature that any patient with chronic or unresolved laryngitis, hoarseness, aphonia or dysphasia should be evaluated for laryngeal, thyroid or other malignancy.

This in addition to the risk factor of being a long time smoking should have thrown up red flags to any health care provider.

I believe that the standard of care was not met (if laryngitis was the only diagnosis repeatably given over 4 months!).

The difficult part to prove is did the failure to meet the standard of care cause harm to your mother.

Adenocarcinoma is slower to grow than large cell carcinoma which doubles rapidly. It could be argued that adenocarcinoma that has distant metastases (stage IV) would have been present for quite some time.

I hope this helps and I wish you the best for you and your family.

-Q

 

[lost in ak]

We went to her oncologist today after her MRI of her brain, they found two more cancerous spots. I asked her oncologist if we would have known about the cancer a year ago would her cancer be as severe as it is. She said once the tumor damaged her vocal cords she was probably at a stage 2. She also said she has cured people in that stage, or they went into remission. She stated her primary tumor is the lung. It is hard to say what would have been, I am well aware that hindsight is 20/20 but I feel we have been robbed of precious years with our mother, because this doctor did not use common scence. I will keep you posted after I talk to an attorney.

Thank you,

 

[rmet4nzkx]

You still didn't answer the question, after your mother first presented with her problems with her voice, at what point did she return to her doctor and say, this isn't helping and/or this is getting worse, when did that happen? Did the medication help some at first? How long did she have the problem before going to the doctor and what, if any other symptoms did she have?

The big problem is your best witness, the onocologist can't even say that this could have been stopped and even if she was at stage 2 and had damaged vocal cords when she first presented to the doctor, that the cancer had not already spread to other parts of her body or that it settled there first and was treatable. If that was the only place it had spread to, then maybe it was treatable or that she would survive the treatment. There may be things in her medical record that would give clues, but if it depends on testimony of the onocologist, the next question they will have to answer will be, have you cured all patiends with stage 2 cancer? Or something along those lines.

The facts are that: the cancer has spread to the bone, liver, vocal cords, thyroid and brain, do you really believe that chemo, surgery and radiation, all of which are devistating to the body, would have changed the outcome or improved her quality of life?

I had a client who suddenly couldn't swallow his medication so I sent him off to the VA where he was in a daily treatment program, he was seen the next day, Xrayed and informed he had a hernia, but given no instruction common for the condition. The next week I sent him back for further diagnostic consultation. It was determined that he had Esophageal cancer, he also had quit after about 20 years of smoking. The next week he had surgery and later chemo and radiation all this within 2 weeks of first symptom. He was never healthy enough for any reconstructive surgery and died less than 1 year later, even with swift intervention at the first symptom. Others have lived longer and with better quality of life without treatment.

Now an attorney may find something in your mother's records that suggests otherwise, but realize that it is very possible that even if she had been sent that day to an ENT, that the outcome may have been the same and you may not have a case with enough merit for an attorney to take on contingency. Most likely, smoking caused both your mother's stroke and her cancer, not a doctor's negligence, so unless the record shows that your mother was constantly complaining about the problems with her voice the entire time and/or asking for referrals to ENT or asking for Xrays, your feeling of hindsight are not enough to make a case with merit. Please keep us updated.

 

[ellencee]

From my consulting experience, examples of medical malpractice for the failure to recognize and treat cancer were of x-rays that clearly showed suspect lesions and either the radiologist did not recognize the obvious or the physician failed to follow-up on the findings and serology tests that revealed a high 'cancer count' and the physician failed to follow-up. I have not seen a claim such as this make it out of the attorney's office.

EC