$1,890,000 for Failure to Diagnose
Rare But Curable Placental Cancer
A 34 year old housewife gave birth by cesarean section without complications. Ten weeks later, she presented to her primary care physician (PCP) with complaints of continuing post-partum vaginal bleeding. The PCP knew that this was abnormal and he performed a urine pregnancy test which was negative. He also ordered a blood pregnancy test and referred his patient to an ob/gyn specialist. The Plaintiff saw the ob/gyn the following day. The ob/gyn prescribed methergine to help control the bleeding. He also ordered a pelvic ultrasound for a suspicion of retained placenta and Plaintiff was instructed to call for a follow up appointment after the ultrasound.
Two days later, Plaintiff had her blood pregnancy test which came back positive. The PCP circled the positive result and admitted that he knew the differential diagnosis for a patient with prolonged vaginal bleeding and positive blood pregnancy test included life threatening conditions such as ectopic pregnancy and/or cancer. However, the PCP never called, faxed or notified the ob/gyn of the positive blood pregnancy test result, a classic red flag for choriocarcinoma, a rare but curable form of placenta cancer. The PCP testified that he sent a form letter to Plaintiff and left a voicemail message requesting that she call to schedule an appointment to discuss her test results but she never did.
Four months after delivery and six weeks after seeing her PCP and ob/gyn, Plaintiff experienced a sudden onset of severe headaches with neurological deficit and vomiting. She was hospitalized with an intracerebral hemorrhage and died two days later. The University of Miami organ harvest team performed surgical pathology on a lung tissue specimen and diagnosed metastastic choriocarcinoma.
P&K retained an expert placental pathologist who re-examined the placental tissue slides taken after the delivery. The original pathology report showed no abnormal findings. However, Plaintiff’s expert testified that one of the three tissue slides showed a very slight abnormality and that the hospital pathologist should have identified this and sent the tissue out to a specialist for a second opinion. The Defendant pathologist’s position was that this was a very rare form of cancer which is never diagnosed on routine placental review.
All of the doctors argued that Plaintiff was at fault for failing to schedule a routine six week post-partum exam as instructed, waiting another month with ongoing vaginal bleeding without calling her doctors, failing to complete a pelvic ultrasound ordered by her ob/gyn, and failing to return to either her PCP or ob/gyn for follow up as instructed by both doctors.
Plaintiff was survived by her husband and two minor children. The case was settled after Plaintiff’s liability experts were deposed (placental pathologist, family medicine, internal medicine, gynecological oncology, medical management/quality assurance). P&K recovered a total $1.89 million from the PCP, the pathologist and the uninsured ob/gyn.