Prostate cancer is a dreadful disease. While not 100% accurate doctors use diagnostics tests to doctors to determine if a patient has the cancer. Yet due to the chance of false negatives (a negative test result although the patient in reality has cancer) physicians have to follow up and repeat tests as appropriate when patient symptoms and screening tests keep showing the possibility of cancer. Not doing so might reslt in a malpractice claim.
In one published claim a man told his doctor that he was having urinary frequency and burning. The doctor started him on antibiotics and refered the man to a urologist. The urologist conducted a cystoscopy which revealed that the man had an enlarged prostate. The urologist also ordered a PSA blood test which registered a 16.3 (a level above a 4.0 is generally thought to be high). Therefore the urologist did a biopsy 2 months later. The biopsy was interpreted by a pathologist as showing no evidence of cancer.
The following year the individual returned to the urologist. On this occasion the PSA blood test was a 2.9 (normally regarded as in normal range). The urologist decided that the man had BPH (a noncancerous enlargement of the prostate). Three months later the patient saw the PCP for fever and nocturia (having to urinate during the night). The physician started him again on antibiotics. A follow up urine culture showed up negative. The primary care physician consequently referred the patient to the urologist. The urologist took a PSA test which came back a 6.4 (again, high).
A biopsy examines parts of the prostate. Thereby, it is possible for a biopsy to miss the cancer. Yet, the urologist decided to rely on the preceding years biopsy and to not perform another one as a follow up. Instead, the urologist failed to follow up on the male’s symptoms and high PSA.
A year later the man returned to his family doctor. Complaints continued to include nocturia. On physical examination the doctor documented that the individual had a highly enlarged prostate. Yet, the doctor did not order a PSA or re-refer him to a urologist. Regular blood testing four months afterwards revealed that the male patient’s PSA was at 7.4 Neither doctor followed up in any way.
The next year the family doctor noted that the PSA level was 9.8 Once more, no follow up or referral to a urologist. Yet an additional year and the man continues to have problems with nocturia. This time the PSA was 9.7 No follow up and no referral. Five years after the person’s first complaints of urinary problems the family doctor again recorded a considerably enlarged prostate gland and a PSA that had now risen to 31. The physician at last refered the patient back to the urologist.
The urologist confirmed that the patients prostate was enlarged and started the patient on antibiotics for (two weeksto be followed by another PSA blood test. Once the PSA test was done 2 weeks later it showed a 33. A biopsy was then at last done which showed cancer every sample taken.
Testing later revealed that the man had prostate cancer which had spread to the lymph nodes, the liver and the bone. Regardless of a course of hormone therapy and radiation therapy the patient died nearly 18 months subsequent to his diagnosis. The law firm that handled this matter announced that a settlement in the amount of $1,000,000 was reached in the case.