Case details

Defense: Classification of type of cancer was not negligent

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
breast, death cancer
FACTS
In October 2014, plaintiff’s decedent Natalia Walker, 26, an employee of a computer technology company, was early in her first pregnancy when she was diagnosed with cancer in her right breast at UCLA Santa Monica Medical Center. Dr. Nicole Dawson, a pathologist, interpreted the tissue from the initial breast biopsy to be estrogen receptor positive invasive ductal carcinoma, with immunohistochemistry testing “equivocal” for the presence of HER2 gene amplification. The tissue slides were sent to the cytogenetics lab at UCLA Pathology & Lab Medicine for FISH testing to determine HER2 status. The first 20 cells tested in the lab revealed a HER2 ratio of 2.85 with an average copies per cell of 4.0. A third set of 10 cells were then tested with results below 2.00, but those cells were not included in the test results. Instead, photos were taken of the two initial slides, and Walker’s treating oncologist was informed of the HER2 positive diagnosis in a surgical pathology report signed by Dawson. However, the final surgical pathology report included a medical record number that did not correlate with Walker. A PET scan performed on Nov. 3, 2014 revealed the presence of Stage IV metastatic disease with spread to the lungs, right humerus, spine and pelvis. Walker was subsequently treated for HER2 positive breast cancer with chemotherapy and HER2 antibodies over the next 20 months. In June 2016, Walker sought to be included in a clinical trial for HER2 positive patients. As a result, Dr. Michael Press, a pathologist who handles cancer research at the Keck School of Medicine of the University of Southern California, in Los Angeles, analyzed the additional slides from the original tissue block and found that the slides showed no evidence of HER2 gene amplification. A re-biopsy of the breast mass was also interpreted at that time to be HER2 negative, as was testing of Walker’s pathology from a bilateral salpingo-oophorectomy in September 2016. By that time, Walker’s cancer had already spread to her brain and liver. Although Walker was switched to hormonal therapy designed to target HER2 negative breast cancer in July 2016, she continued to decline until the time of her death on June 30, 2017. The decedent’s husband, Kyle Walker, acting individually and as successor-in-interest of his wife’s estate, sued Dawson and the operator of the UCLA medical centers, the Regents of the University of California. Mr. Walker alleged that the defendants misdiagnosed his wife’s condition and negligently treated her. He also alleged that the defendants’ actions constituted medical malpractice. Barbara Kort Women’s Imaging Center; Ronald Reagan UCLA Medical Center; UCLA Medical Center, Santa Monica (now known as UCLA Santa Monica Medical Center); and UCLA Pathology & Lab Medicine were also all named as defendants, but they were dismissed from the case once it was determined that they were all admitted agents of the Regents of the University of California. Plaintiff’s counsel argued that Ms. Walker was negligently diagnosed with HER2 positive breast cancer in October 2014, resulting in the wrong treatment being administered for Ms. Walker’s cancer for the first 20 months. Counsel also argued that the photos taken of the original slides should have alerted Dawson to the erroneous diagnosis, as should the results of the third set of cells analyzed in the FISH lab at the UCLA Pathology & Lab Medicine. Plaintiff’s counsel further argued that it was below the standard of care for Dawson to have signed a surgical pathology report without noticing that the medical record number belonged to another patient and investigating that discrepancy. Defense counsel argued that the care rendered to Ms. Walker by Dawson and all other providers at UCLA complied with the standard of care at all times, including the original analysis performed in the cytogenetics lab in October 2014. Counsel contended that anything over 2.0 was considered HER2 positive in 2014 and that as such, the standard of care did not mandate any further investigation into the FISH ratio of 2.85. Counsel also contended that the guidelines in place nationally in 2014 required that the breast cancer be characterized as HER2 positive. With regard to the erroneous medical record number, defense counsel argued that the incorrect number was clearly only a typographical error that did not impact Ms. Walker’s patient care at all. In addition, counsel argued that evidence presented showed that Ms. Walker’s breast cancer behaved clinically like a HER2 positive tumor, responding better to chemotherapy and HER2 antibodies than it ever did to hormonal therapy., Ms. Walker was diagnosed with breast cancer in October 2014. She was underwent chemotherapy and received HER2 antibodies over the first 20 months of treatment. Walker was then switched to hormonal therapy designed to target HER2 negative breast cancer in July 2016. However, her cancer spread to her brain and liver, and she continued to decline until she ultimately died on June 30, 2017. The plaintiff’s oncology expert opined that if Ms. Walker had been correctly diagnosed in October 2014, she would have been treated with state of the art hormonal therapy, palbociclib, and that the treatment would have extended Ms. Walker’s life expectancy by another two years. Mr. Walker, individually and on behalf of his wife’s estate, sought recovery of noneconomic wrongful death damages for the loss of two additional years of his wife’s love, companionship, comfort, care, assistance, protection, affection, society and moral support. In addition, he alleged that Ms. Walker had the capacity to work and that with a correct diagnosis, she would have earned some $340,000 before her death and would have provided another $55,000 in household services during that time. Defense counsel asserted that Ms. Walker would not have lived past June 30, 2017, even if Ms. Walker had been diagnosed initially as HER2 negative and treated with hormonal therapy. Specifically, counsel argued that the data supporting the use and efficacy of palbociclib in pre-menopausal females was not yet well known in October 2014 and, therefore, would not likely have been a part of Ms. Walker’s initial therapy. Defense counsel contended that Ms. Walker worked for six months in the United States for a computer technology company and that there was no evidence that Ms. Walker’s ability to work or provide household services would have been altered by a diagnosis of HER2 negative breast cancer, as opposed to HER2 positive breast cancer. At the conclusion of the plaintiffs’ case, Judge Holly Kendig, as a partial judgment of nonsuit, struck Mr. Walker’s claim for economic damages (for the alleged loss of earnings and household services).
COURT
Superior Court of Los Angeles County, Los Angeles, CA

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