Michael Gunter, a military veteran of the Vietnam War and retired U.S. Postal Service worker, began prostate specific antigen (PSA) screening when he turned 50 years old. PSA is a protein, which if elevated, can suggest the presence of prostate cancer. Gunter sought his routine care at the Marion VA Medical Center, who he would later file a medical malpractice claim against for a failure to diagnose. He was recently awarded a $1.93 million verdict in a federal court after the completion of a four-day bench trial.
Gunter was seeing his primary care physician, Dr. Razi Sami, who ordered the initial PSA. A result of greater than 4.0 is considered to be high and Gunter’s result measured 4.5. Dr. Sami determined his PSA was elevated and began a plan that included monitoring every six months. Gunter next visited Dr. Kent Johnson, a Marion urologist, who had a PSA conducted which indicated a level of 5.57. Johnson believed that Gunter had benign (non-cancerous) prostatic hyperplasia (BPH) and would later say that there was a 42% chance of the existence of cancer.
Six months later, Gunter returned to Dr. Sami for a PSA which measured 4.96. Over the next year, Gunter saw Steve Martinez, a physician assistant, who obtained PSA results of 7.25 from a test. Martinez ordered a return visit in three-months as his PSA levels continued to rise. Gunter’s next two visits were with urologists Dr. Adiraju Palagiri and Dr. Gerald L. Andriole where it was revealed that his level had risen to 10.81 and he began treatment at Washington University School/Barnes-Jewish Hospital.
A laparoscopic bilateral pelvic lymphadenectomy was performed and 12 lymph nodes were extracted, four of which were determined as being cancerous. Gunter began having erectile dysfunction and increased problems with his existing post-traumatic stress disorder. Andriole would later testify if a biopsy had been conducted in the prior years, the cancer would likely have been detected much sooner–before it had developed further.
During the case, Dr. Johnson stated that he always discussed the options associated with a biopsy in these circumstances and that he had done so with Gunter three years earlier. The plaintiff attorneys determined that the medical records did not show that any such discussions between Johnson and Gunter had ever occurred.
U.S. District Judge Staci Yandle heard this case of medical malpractice and was to render a decision. Gunter’s further testimony stated that Johnson had never told him about his assessment of a 42% chance of having prostate cancer, a fact that he said would have been alarming. Judge Yandle felt that Gunter was credible. She explained that had Gunter been informed of this possibility, he would have wanted to take action. Yandle found that Johnson did not adhere to the standards of care in treating the problem. The judgment of $1.93 million was for damages including pain and suffering, disfigurement, losses of normalcy, and a reduced life expectancy.
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