Rectal Cancer

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CASE: Rectal Cancer

FACTS: This is a medical malpractice claim in which the 60 year-old plaintiff died from a delay in the diagnosis and treatment of rectal cancer. He was a patient of the defendant, family physician, for many years. Despite the acknowledged standard of care requiring screening for rectal cancer for patients over 50 years of age, the defendant never recommended annual screening by fecal occult blood cards or sigmoidoscopy; and when blood was found on rectal exam, the defendant failed to order diagnostic colonoscopy. In June of 2000, the plaintiff saw the defendant doctor and reported “dots” of blood on tissue paper after bowel movements. A hemoccult card confirmed the presence of blood. Despite those findings, no colonoscopy was ordered and the bleeding was attributed to hemorrhoids. One year later, a stool sample again tested positive for occult blood. Still, no colonoscopy was ordered. In August of 2001 (14 months after the first finding of rectal blood), the plaintiff made an acute visit to the defendant doctor because of increasing complaints of rectal bleeding. At that visit, an obvious mass in the rectum was found.

The defendant doctor altered the plaintiff’s medical records. The defendant made numerous after-the-fact, yet undated, alterations to the plaintiff’s medical records prior to forwarding them to the plaintiff’s lawyer. Those alterations contained previously undocumented allegations that the defendant doctor had discussed the risk of rectal cancer with the plaintiff, recommended a colonoscopy, and that the plaintiff had refused that recommendation. Plaintiff’s counsel obtained an unaltered copy of the plaintiff’s records from another medical care provider who had received a copy before the diagnosis of cancer was made. The unaltered records revealed an absence of any such recommendation and refusal.

The case involved an interesting jurisdictional issue because the defendant doctor practiced in a neighboring state and the care in question was provided in that state. Defendant objected to New Hampshire jurisdiction, but the trial court overruled the objection after applying the tests set out in Phelps v. Kingston, 130 N.H. 166 (1987) and Mosier v. Kinley, 142 N.H. 415 (1997).

DEFENSE: The defendant denied negligence and causation, and alleged that the altered records accurately reflected the facts, although acknowledging that they would likely be misleading.

INJURIES: The plaintiff suffered an agonizing illness and death from rectal cancer. He experienced extreme mental pain and suffering, along with the loss of enjoyment of life. His estate incurred medical, funeral, and other expenses. The estimate of economic loss was $557,000.00.

SPECIAL DAMAGES: $290,675.00 in medical expenses for treatment of the cancer, but the defendant contended many of these expenses would have been necessary even with timely diagnosis and treatment.

SETTLEMENT: The parties agreed to settle for a confidential amount.

PLAINTIFF’S COUNSEL: Michael P. Hall, Esquire (deceased) and Randolph J. Reis, Esquire (Reis Law, PLLC)

NAMES/COUNTY: Anonymous v. Anonymous