Case details

Cancer went untreated due to patient’s follow-up delay: defense

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
cancer, prostate
FACTS
On April 5, 2012, plaintiff Eddie Hammon, 71, a special education teacher, presented to Dr. Anthony Horan, a urology specialist, after a screening found his prostate-specific antigen (PSA) to be modestly elevated. Hammon was previously sent by his primary care provider for a PSA study to screen for prostate cancer on Dec. 5, 2011. The result was 5.33. As a result, the primary care provider referred Hammon to Horan. During the first visit, on April 5, 2012, Horan took a history and conducted a physical examination. Horan believed that Hammon’s modestly elevated PSA was secondary to an enlarged prostate, otherwise described as “benign prostatic hyperplasia,” or BPH. As a result, Hammon was given some medication and told to return in 90 days for a repeat PSA study. However, Hammon did not return for a second visit with Horan until Dec. 5, 2013. By that point, the primary care provider had repeated the PSA studies in August 2013 and again in October 2013, and they came back at 6.67 and 5.8, respectively. During the August 2013 visit, Hammon was told by his primary care provider to return to Horan, but, as noted, Hammon did not return until Dec. 5, 2013, or five months later. At that time, Horan discussed having Hammon undergo a microwave procedure to shrink the prostate, but he did not get a repeat PSA study. Horan admitted that he did not know the exact value of the PSA results and claimed that he depended on Hammon’s description of the values being initially high, but then fell back a little bit. As a result, Hammon was placed back on Finasteride and told to return in 90 days. Hammon returned to Horan on April 16, 2014 and reported that his underlying urological problems had become worse. Horan again did not get a repeat PSA, but concluded that Hammon’s symptoms were caused by BPH. A microwave procedure was subsequently carried out at Horan’s office on May 21, 2014, and Hammon was told to return for a follow-up. However, Hammon never saw Horan again. In September 2014, the primary care provider obtained a PSA that reported out at 8.8. As a result, the treating physician directed Hammon to a urologist, but Hammon did not see another urologist until February 2015, when his PSA was 37. A biopsy proved prostate cancer, with a Gleason score showing that most of the tumor is grade 4 and less is grade 3, so the grade were added for a Gleason score of 7. Hammon sued Horan, alleging claims of medical malpractice. Hammon claimed Horan was negligent on April 5, 2012, and at every visit thereafter, for not doing a repeat PSA and for not offering a biopsy at any time. Defense counsel contended that by not returning 90 days after the initial visit in April 2012, Horan was deprived of finding out how Hammon’s PSA did while Hammon was on Finasteride. Counsel explained that when a PSA is elevated secondary to BPH, as opposed to prostate cancer, Finasteride typically cuts the PSA in half and that when the PSA does not fall, despite a patient taking Finasteride, many urologists will strongly consider prostate cancer as an alternative explanation for the abnormal PSA. Defense counsel contended that if Hammon had returned within a reasonable amount of time, it was likely that the PSA would have been unchanged since it was still in the 5 to 6 range in August 2013 and October 2013, respectively. However, counsel argued that by Hammon not returning, Horan did not have a chance to offer a biopsy and that if the prostate cancer had been diagnosed (as all sides and witnesses agreed that, in retrospect, Hammon likely had prostate cancer for years as of April 2012 to July 2012), the suit would never have been filed and no one would have to argue about what took place 20 months later beginning in December 2013 and moving through the May 2014 time frame., In February 2015, Hammon went to see another urologist and it was determined that his PSA was 37. A biopsy proved prostate cancer, with a Gleason score showing that most of the tumor is grade 4 and less is grade 3, so the grade were added for a Gleason score of 7. As a result, Hammon went to UCLA Medical Center, in Los Angeles, for further evaluation and imaging studies in March 2015. It was documented that Hammon had widespread metastatic disease to the ribs, sacrum, and spine. He was ultimately diagnosed with Stage IV (terminal) prostate cancer, and he received chemotherapy at UCLA. Plaintiff’s counsel contended that with timely diagnosis and treatment, Hammon would have been completely curable. However, testimony produced to the jury indicated that Hammon was expected to have a life expectancy of approximately 18 to 24 months. Hammon worked for the Wasco Unified School District as a special education teacher, and is currently still teaching. As a result, he was fully insured, and did not seek recovery for any medical costs. Thus, plaintiff’s counsel asked the jury to award $975,000 for Hammon’s past and future pain and suffering.
COURT
Superior Court of Kern County, Kern, CA

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