A 41-year-old Pennsylvania woman had a robot-aided hysterectomy and lymph node operation after receiving a diagnosis of having endometrial cancer by a gynecologist. She had signed a “consent to surgery/anesthesia” document agreeing to the procedures. Following the surgery, the patient was told that her samples were defined as “pre-cancerous”, which she claimed to not have been made aware of. The pathology lab stated that no actual presence of cancer existed. The woman pursued a claim of medical malpractice citing negligence by the doctor in failing to properly inform and proceeding with an unnecessary surgery.
The suit claimed that the physician did not adhere to standards of care by unnecessarily recommending a hysterectomy procedure that targeted cells that were not truly cancerous. The physician claimed that the results of the pathologist were presented to her and that the potential results and options relating to surgery were discussed. The pre-cancerous cells on the report were defined as having the potential to develop into cancer. The four-day trial resulted in a jury verdict favoring the defendant.
This case differs from another situation that can arise in medical diagnosis referred to a “false-positive”. These occurrences are fairly common and can result in severe consequences such as unnecessary procedures, treatment, and emotional distress. Individuals who have been informed that they have a terminal illness that resulted from a false-positive test have taken drastic measures such as leaving their jobs, gifting their retirement savings, and more. Nationally, the costs associated with false-positive diagnoses are estimated at roughly $4 billion annually. Cancer is one of the most misinterpreted or falsely detected conditions. Mammograms for breast cancer are inaccurate slightly over 10% of the time.
The National Institutes of Health conducted a study of over 60,000 patients who were subjects of lung, prostate, colorectal and ovarian screening for the presence of cancer. They sought to gain a better understanding of the accuracy of screening. Individuals who took part in testing were 50% likely to have a false-positive screening within their 14th test. The medical community certainly has further work ahead in developing more accurate methods of diagnosis. Doctors are advised to discuss the potential for false-positive screenings with patients as part of the process of informed consent. In addition, it is always important to obtain multiple screenings that will actually confirm the initial diagnosis.
Other conditions that may generate false-positives include hepatitis and HIV. Darrell Ranum, President of Patient Safety at The Doctors Company, indicated that although false-positives are common, they rarely progress into claims of malpractice. In one case, a tumor found on a young man’s arm was determined to be cancerous. The arm with the tumor was then amputated; however, it was found that the tumor was actually benign.
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