Timeline of Relevant Medical Events
December 2024
Routine surveillance performed.
Bloodwork/DNA screening: Positive for metabolic activity (suggestive of residual disease).
CT Scan (Dec 27, 2024) – Chest, abdomen, pelvis with contrast.
Radiology Report Conclusion: No evidence of metastatic disease.
Based on this report, the treating oncology team continued surveillance and did not initiate chemotherapy.
May 2025
Repeat surveillance CT scan performed.
This time, metastatic disease in the abdomen was identified.
The May 2025 radiologist compared images with the December 2024 study and documented: "The metastatic lesion was visible in December 2024 but not reported at that time. Tumor clearly increased in size between Dec 2024 and May 2025."
This discrepancy suggested that the December scan was either:
Misread (missed lesion), or
Misreported (known but omitted).
June 2025
Surgery attempted to remove abdominal tumor.
Intraoperative findings: cancer had spread too extensively → resection not possible.
Patient deemed inoperable and terminal, transitioned to palliative care.
Allegations of Negligence
Failure to detect or report visible metastasis on Dec 27, 2024 CT scan.
Result: 6-month delay in diagnosis and initiation of chemotherapy.
Patient and family believe that:
Chemo should have been restarted in Dec 2024, not June 2025.
Earlier treatment may have slowed progression, preserved surgical options, or improved survival/quality of life.
Questions for Expert Review
Standard of Care (Radiology):
Should the metastasis have been identified and reported in December 2024?
Was the lesion visible to a reasonably prudent radiologist?
Was there a departure from accepted radiology practice?
Causation (Oncology/Survival Impact):
If metastasis had been reported in Dec 2024, would treatment (e.g., resumption of chemotherapy, earlier surgery, or other interventions) have:
Prolonged survival?
Preserved eligibility for resection?
Improved quality of life?
Damages/Outcome:
Did the 6-month delay in diagnosis and treatment materially worsen prognosis?
Would timely intervention in Dec 2024 have avoided terminal status/palliative-only care?
recommendations.
Files:
No questions yet!
Do you believe there might have been medical error?
If this is colon cancer, it is definitely a deviation from the care, as it was an oligometastatic disease, and you can do metastatectomy.
Do you believe there might have been causation (i.e. the medical error resulted in an injury)?
we do need to know the type of cancer. if this is colorectal cancer, it should have been picked up for surgical resection. Definitely, there is a deviation from the standard of care. for causation, we need to know the pathology
What makes you a good expert for this case?
I have testified in court in MA and CT as well as in NH. I have done depo in CT, OH, IL, NH
How often do you encounter cases similar to this one in your practice?
it is not uncommon. it should have been reported
Do you believe there might have been medical error?
I am a medical oncologist and will testify on causation. Therefore, I will rely on the radiologist's testimony for the standard of care. For causation, this appears to be a fairly slowly growing cancer. Unfortunately, the type of cancer is not described, but metastatic cancers of any type are not curable. However, they are treatable, and early treatment provides longer survival and lower burden of suffering. Immunotherapy provides a chance for long-term survival for years, with no symptoms, in many solid cancers.
Do you believe there might have been causation (i.e. the medical error resulted in an injury)?
Addressed above. Much depends on the cancer type and its underlying prognosis.
What makes you a good expert for this case?
The Hematologist/Oncologist who wrote this review had been Associate Professor of Medicine while a full-time attending at the University Hospital of a Medical School until 2009. Prior to 2004 had been an Associate Clinical Professor of Medicine. He is currently in private practice. He is first author of over thirty academic articles, chapters and several books. Over the past two decades he held the positions of Interim Chief of Hematology and Oncologyat a Medical School, Director of the Cancer Center at a teaching community hospital; Chief of Hematology and Oncology and Chief of Service at a large municipal Medical Center and concurrently Director of the Cancer Center of several hospital in a network; and Co-Director of Oncology at an affiliated University Hospital and Medical Center. He developed and ran two clinical research programs as well as a community advocacy group, a consulting group, and a non-profit educational institution. In addition to Internal Medicine and Oncology, the reviewer is Board Certified in Quality Assurance and Utilization Review and holds an MBA. He was listed several times as the best in his specialty by the Castle Connolly Guide to America's Top Doctors. I have significant experience as an Expert Witness.
How often do you encounter cases similar to this one in your practice?
Commonly, both a practicing physician for 35 years and an Expert.
Want to open a case or submit response?
Comments are accepted only from Medical Oncology experts.