Delayed diagnosis of prostate cancer cases are all too common. One common type of medical error that forms the basis for these cases occurs when the male patient's family doctor (1) actually screens the patient for prostate cancer by monitoring the level of PSA (Prostate Specific Antigen) in his bloodstream, (2) notes abnormally elevated levels of PSA and yet (3) neither informs him of abnormal results nor orders diagnostic tests, such as a biopsy, to rule out prostate cancer. The three cases below illustrate this situation.
In this case a male patient followed up when advised by his internist that he probably had cancer. The diagnosis: advanced prostate cancer. The issue in this case was that the internist did not inform the patient that he might have cancer until the third year of elevated PSA test results. The year before the patient's PSA level had risen to 13.6. Two years prior to that it had been at 8.0. During these years the internist took no action to rule out prostate cancer as the source of these elevated readings and did not inform the patient. By the time he was diagnosed surgery was not among the treatment options. Instead the patient underwent radiation therapy and hormone therapy in an attempt to slow down the further progression of the cancer. The law firm handling this matter reported that the case went to mediation and settled for $600,000.
In this case a male patient found out when he was 64 years old that he had prostate cancer that had spread to the seminal vesicles. He only discovered that he had cancer because a family member urged him to consult with a urologist. It was the urologist who diagnosed the cancer. The patient's family doctor, a general practitioner, had been screening the patient for prostate cancer through PSA testing. Yet, he never told the patient that his PSA level had been elevated and rising - from 5.95 and 5.33 to 7.04 over a period of sixteen months. Not only did this general practitioner not tell the patient that this readings were abnormal and might be due to prostate cancer, he actually told the patient that the results were normal for a man his age. The law firm that handled this matter reported a settlement in the amount of $1,500.00.
In this case, a male patient was diagnosed with advanced prostate cancer at age fifty after switching doctors. His prior doctor, a family doctor, had ordered a PSA test to screen for prostate cancer when the patient had gone in for his annual physical five years earlier. Even though the test results came back abnormally high the doctor never repeated the test and never ordered a biopsy to rule out prostate cancer. By the time he was diagnosed his only options for treatment was to attempt to slow the progress of the cancer. A cure was no longer possible. The law firm that handled this matter reported that the case settled for $750,000. This settlement amount represents the maximum value of the claim for him and his wife ($250,000 each due to caps of non-economic injury) and his estimated lost earnings.
As the above cases illustrate doctors sometimes follow the guidelines in performing screening for prostate cancer yet when the test results are abnormal they do not follow through. At a minimum they should inform the patient that the results of the screening tests are abnormal and refer the patient to a urologist. Another option is to order suggest diagnostic testing, such as a biopsy. When they do nothing in the presence of abnormal test results and the patient later learns that he had prostate cancer and that the delay resulted in it spreading outside the prostate thus limiting treatment options and decreasing his chances of surviving the cancer, the patient may have a claim for medical malpractice.