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  • Cancer Misdiagnosis—Failure to Communicate and Surveil Lung Nodule, Leading to Fatal Lung Cancer: Smith v. Ascension

Sommers Schwartz attorney Andy Dragovic filed a medical malpractice and wrongful death lawsuit on behalf of a 71-year-old man who died of lung cancer due to his family physician’s failure to communicate and surveil a 2mm lung nodule finding.

Under the defendant primary care physician’s direction, the decedent underwent a CT lung screening due to his status as a long-term smoker suffering from COPD. The radiologist conducting the study reported a solitary 2 mm non-calcified nodule. Abnormalities were also demonstrated in the left apical lung, and the radiologist recommended a one-year follow-up for surveillance of the pulmonary nodule. The defendant received the report but failed to communicate the findings and recommendations to the plaintiff. No subsequent surveillance of the pulmonary nodule was ordered, and no referrals to specialists were made.

Over the next two and a half years, the decedent reported for routine check-ups and other appointments with the defendant on twenty occasions. His symptomology evolved from frequent to chronic cold symptoms during this period, and his COPD diagnosis became chronic. At no point did the defendant order lung imaging or perform any other workup for lung cancer. No surveillance of the known lung nodule was performed as recommended, and the decedent was never informed of the original CT findings.

Eventually, the decedent sought the opinion of a pulmonary specialist who ordered a new CT of the lungs, which revealed a 6.5 cm mass in the upper left lobe with a high suspicion of underlying malignancy. A CT biopsy confirmed squamous cell carcinoma of the left upper lobe. He was referred to an oncologist who questioned him about the 2 mm nodule found in the original CT scan recommended by the defendant. The decedent and his wife were stunned as they never knew anything about it. 

Due to the size of the tumor, its location and resection estimates, and the decedent’s now very poor pulmonary function test results, he could not tolerate a lobectomy. Concurrent chemo-radiation therapy was ordered, to which he responded poorly. The decedent died three months after the cancer diagnosis and three years after the original CT scan.

According to expert testimony, the standard of care required the defendant to communicate the relevant findings of the lung screening, to recommend surveillance, to make timely and appropriate referrals to specialists, to attribute the decedent’s persistent and worsening respiratory symptoms to possible lung cancer, and to perform an appropriate workup to either confirm or deny the diagnosis. Had the defendant exercised the reasonable care and diligence required of family medicine physicians, specifically by performing a CT lung screening one year after the initial screening, the decedent would have had viable surgical and nonsurgical treatment options and likely avoided premature death.

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