Delay In Lymphoma Diagnosis

[Kolli]

I saw my physician for a lump in my neck back in September of 2009.  He referred me to an ENT who immediately thought it was a cyst and sent me to have it drained through a FNA.  The results from that apparently came back negative and the lump went away.  One month later, the lump reappeared and the ENT doctor said it would continue to do so, but it was not dangerous and I could drain it or leave it alone.  I elected to leave it alone.  Then, in early January 2010, my back, shoulder and leg started hurting very intensely and I saw my doctor.  He said it must be from working out too hard or my diabetes is causing me to have health issues.  The pain persisted to the point where I was placed on several pain medications and muscle relaxers over the next 6 months.  My doctor could not find anything wrong with me.  I began to lose my appetite and I lost about 20-25 lbs.  It was hard to breathe sometimes due to the pain in my shoulder and back.  I could not sleep at night due to the back pain, but x-rays were negative for any broken bones.  My doctor ran an LDH test which came back at 1,235(normal is under 250).  He ran a 2nd test a couple of weeks later and it was at 770.  He ordered a 3rd test, but the lab ran the wrong test and we never got the results.  He said it was not a big deal since the numbers seemed to be improving.  He diagnosed me with Pleurisy and told me to take pain medicine and go easy on the workouts.  After 6 more weeks of pain and trips to the ER for morphine injections, he said my diabetes was out of control and it was hurting my body.  It had been about 10-11 months since the initial onset of symptoms began at this point.  He referred me to a diabetes specialist to learn how to better manage my diabetes.  I was itching all over and having chills and sweating at night.  The pain in my back got worse and he then referred me to an orthopedic doctor who ran an MRI.  It showed two cracked vertebrae and a large mass in my mid-lower back.  He then ordered a CT scan that revealed a huge tumor in my spleen area.  They diagnosed me with Stage IV Lymphoma(DLBCL).  They also said that I had a fracture or lesion in my femur and I was to be on crutches for 10 weeks until they could surgically repair the bone.  I started chemo and went through 8 rounds of CHOP-R therapy.  Then, I went through 6 weeks of abdominal radiation, followed by 2 additional rounds of ICE chemo after the tumor began growing again.  I was told I needed a stem cell transplant.  I went through that while being hospitalized for almost a month.  I am now out and they say there is still a 1-2 CM mass in my abdomen.  I am looking at another month or so of radiation.

I am a 37 year old male with a wife and 2 young children.  They say my prognosis is now looking good since I underwent the stem cell procedure and the year's worth of chemo and radiation.  However, my radiation doctor told me that if this would have been caught back when it first appeared in my neck as a lump, it would have most likely been Stage I and easily treated.  When I was diagnosed, my LDH count was over 3,200.  They told me that was a poor prognostic indicator, along with being diagnosed at Stage IV-B.

I have spoken with a law firm and they said the case would be too difficult to win because of the "burden of proof" factor.  What are your thoughts on this matter?  Any help would be GREATLY appreciated.

Thanks so much!

[Dowle]

Wow, really sorry you have had to go thru all of that.  The first legal issue is, was the failure to get an earlier diagnosis evidence of a breach in the "standard of care"?  In other words, would say 90% of qualified specialists look at your case and say something to the effect of "what the hell was that doctor thinking? Any half competent doctor would have [done this or that} and the diagnosis would have been relatively easy".  The next issue is easier based on what you have said and would be "would an earlier diagnosis have spared the patient very severe damages"?  You must understand that doctors, even specialists, do not have a duty to always make the correct diagnosis.  Wrong diagnosis happens all the time and most times there is no malpractice involved. The question is, did you doctor pay proper attention to all of the symptoms, conduct the correct tests, and reach a reasonable diagnosis based on all of the circumstances?  The reason the first firm turned down the case is because if you sue, the doctor will have the best lawyers with unlimited budgets to find and pay top doctors in the field and who will testify that although an earlier diagnosis would have been great, the defendant doctor at all times used reasonable medical judgment and acted within the standard of care.  Your lawyers would have to spend big bucks to find and use experts saying the standard was breached. Many thousands of dollars, hundreds of hours of work and at best you might have a 50-50 chance of winning and only if you win does your lawyer get paid or even get his money back.  If you are in remission and have a good chance of normal life span, then the case is really difficult because the damages will not be as huge as they need to be. No lawyer would tackle your case unless there was a good chance of a high 6 or even seven figure verdict.  But considering what you have been thru and if the radiologist is correct and most doctors would agree with his opinion, you might find a firm to take the case. You need to find a big one that can absorb the costs and has the manpower to devote to such a case. So keep looking.  The burden of proof(liability[ is a big nut to crack but damages are really what the lawyer was thinking about. Be mindful of the Statute of Limitations in your State.  Google   name of your State medical malpractice statute of limitations ......to find out how much time you have for legal action. Good luck