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Liposarcoma Case

 

This case involves Nassau County medical malpractice sustained by the plaintiff resulting from the misdiagnosis of liposarcoma by the defendant doctor. In January of 2003, the plaintiff presented to his primary care physician with complaints of radiating abdominal pain. The defendant doctor’s impression of the pain was “flank pain”. The defendant doctor testified that the plaintiff reported the pain as occurring after exertion and lifting. There was no evidence that the plaintiff sustained any actual trauma, or any abscess, infection, or prior malignancy.

 

The defendant doctor referred the plaintiff for a CT scan of the abdomen in order to rule out kidney stones as the cause of pain. The CT scan was done on January 22, 2003. The scan was interpreted by doctor #1, who found a hematoma measuring 10.0 x 7.8 x 7.9 cm in the longitudinal, AP and transverse dimensions present. Doctor #1's impression was a right psoas muscle hematoma. According to doctor #1, he tried unsuccessfully to contact the defendant doctor.

 

The defendant doctor testified that he received the radiology report of doctor #1 on January 23 or 24 of 2003. The defendant doctor said that he saw the plaintiff on January 28, 2003 and discussed the finding of hematoma contained on the radiology report, and that his diagnosis was hematoma in the right psoas muscle. The defendant doctor described the size of the mass found on the radiology report at medium.

 

In April of 2003, the plaintiff presented to the defendant doctor with right hip pain and abdominal pain. As of April 25, 2003, the defendant doctor’s impression was hip tendonitis and gastroesophageal reflux disease. The plaintiff underwent physical therapy and returned to the defendant doctor on June 13, 2003.

On July 7, 2003, another CT scan of the abdomen was performed, as was a CT scan of the pelvis. On CT scan of the pelvis, the lesion measured 10.1 x 10.2 x 16.0 cm, and an MRI of the pelvis revealed the lesion as 2.7 x 10.6 x 11.6 cm. According to the CT scan report, there was significant increase in size of the heterogenous right psoas mass, which may represent either a growing neoplasm or abscess. Aspiration biopsy would be more definitive for further assessment. According to the MRI report, the lesion had significantly increased in size compared to the prior CT scan of January 2003, and was suspicious for malignancy. On July 21, 2003, the plaintiff underwent surgery at Hospital #1, wherein pathology noted a 13.0 x 12.0 x 8.0 cm high grade liposarcoma, pleomorphic type and areas with myxoid pattern.

 

The initial history from Cancer Center #1 details the course of events which occurred after diagnosis of cancer:

Post operatively the plaintiff received radiation therapy to the right hemi abdomen and pelvis for 4-5 weeks. He did well until December 2003 when he was noted to have a lesion in the right lung. He had thorascopic surgery done where one nodule on the right side was removed. The plaintiff was then diagnosed as having a metastatic tumor in the right base of the skull and was treated with radiation therapy for one month in February 2004 and then the patient was referred. It was recommended he be treated with “cyberknife.” However, before getting that treatment, new pulmonary metastases were noted, 2 on the right and 1 on the left and the patient was referred for surgery again thorascopically. At that time he was having pain in his left arm and he was worked up with a bone scan and another CT scan and was told about metastatic disease in the left arm and he was also told that he had metastasis in the liver. He then started chemotherapy at Hospital #2 in April 2004.

The plaintiff underwent surgeries at Hospital #1 concerning the pulmonary metastases (e.g., removal of lung lobes, etc.). He underwent hospital admissions at two other hospitals related to the metastatic cancer and therapies (e.g., low red cell count, low white cell count, low platelet count, stomach pain, chest pain, back pain, need for blood transfusions, etc.).

Due to the progressive nature of the metastatic cancer, the plaintiff’s condition deteriorated and he died on October 11, 2005. On the death certificate, the immediate cause of death was listed as “advanced liposarcoma metastatic cancer”.

 

As of January 2003, there was no history of any actual trauma, or any abscess, infection, or prior malignancy. Given the size and location of the lesion which was identified as a hematoma on CT scan, and given the lack of history of any actual trauma, or any abscess, infection or prior malignancy, the standard of accepted medical care in the community required that the defendant doctor rule out a non-benign cause of such mass. The CT scan was ordered to rule out kidney stones. When a lesion of this size and location was found on CT scan, given the lack of history as described above to support a diagnosis of hematoma, the differential diagnosis required ruling out cancer. As such, further work-up of the lesion was required. There is no evidence that the defendant doctor contacted doctor #1 concerning his finding of hematoma.

 

As of January 2003, the defendant doctor should have timely referred the plaintiff for a further work-up of the lesion after receiving doctor #1's report on January 23rd or January 24th. Such further work-up could have included more detailed radiology study of the mass to further delineate it, or included pathology work-up to identify the mass. There is a substantial chance that further work-up of the lesion would have led to identifying it as cancer in a timely and prompt fashion. Further work-up of the lesion in July of 2003 led to the diagnosis of liposarcoma.

 

The defendant doctor committed medical malpractice and departed from accepted standards of medical care in the community by failing to take the action described above. Had the defendant doctor taken the action described above, there is a substantial chance that the liposarcoma would have been timely and promptly diagnosed after he received doctor #1's radiology report on January 23rd or January 24th. The defendant doctor’s failure to take the action described above deprived the plaintiff of a substantial chance of having the liposarcoma diagnosed timely and promptly the radiology report, and of receiving timely and prompt medical treatment for the liposarcoma.

This medical malpractice failure by the defendant doctor was a substantial factor in causing the liposarcoma to not be diagnosed in a timely manner, the plaintiff to be deprived of a substantial chance of having the liposarcoma diagnosed shortly after the radiology report, the plaintiff to be deprived of a substantial chance of receiving timely medical treatment for the liposarcoma and the delay through July of 2003 in diagnosis and treatment of the liposarcoma.

 

If you or a loved one have questions about the timeliness of a cancer diagnosis and have questions about the quality of the medical care you received please call Silberstein, Awad & Miklos' medical malpractice lawyers for answers. Together we will continue our fight against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES in New York and NYC including Manhattan, Bronx, Brooklyn, Long Island, and Queens.

 

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