While a colonoscopy is normally recommended as a screening tool for colorectal cancer for individuals who are 50 years old and older, doctors usually acknowledge that reports of rectal bleeding by a patient warrant performing a colonoscopy regardless of the age of the patient. Regardless of whether a colonoscopy or a sigmoidoscopy is actually done, though, if the examination is not complete and adequate visualization was not achieved, physicians generally recommendedthat the procedure should be repeated. Below we review a matter which alleged that both a family practicioner and a gastroenterologist failed to follow these practices.
In this case, a woman complained to her physician that she was having constipation and detected rectal bleeding during a five week interval. This continued for another month. She was forty six years old at the time. Now the primary care physician scheduled her for a consultation with a gastroenterologist to do a sigmoidoscopy to discover the reason for the bleeding and constipation. Still, the gastroenterologist merely did a sigmoidoscopy as opposed to a colonoscopy. A sigmoidoscopy just lets the doctor examine up to 40 cm from the anus. While the sigmoidoscopy just allows examination of a limited portion of the colon, the doctor noted that the proceedure was not completed and that it had not been possible to examine the full length even of the sigmoid. Despite the poor visualization, the gastroenterologist failed to recommend that the test be done again so as to properly examine the sigmoid.
Five months later, the woman again saw her primary care physician for a yearly physical. She again told the doctor that she was suffering from constipation. The subsequent year, for the third time she told her physician that she was having constipation. A brief time after seeing the physician documented that the patient’s daughter spoke to the doctor about her and the doctor proposed she eat more fiber for irritable bowel syndrome. The doctor also said to the woman's daughter that he would contemplate ordering a colonoscopy at a later date.
At the end of the year, the woman again told her doctor that she continued to experience constipation. The doctor recommended she take lactulose and come back in a month. When she returned as suggested, the doctor noted that a physical examination revealed tenderness in the lower left quadrant and that he could feel a structure consistent with stool in her colon. Finally, the doctor ordered that her TSH level (thinking her symptoms might be thyroid related) be checked and made an entry that he thought a colonoscopy might be necessary.
Around two weeks afterward, the patient ended up in the emergency room because she developed pain and vomiting while prepping for a colonoscopy. The emergency room doctor discovered that she had a distended abdomen and could hear hyperactive bowel sounds. in addition, the woman had abdominal tenderness, primarily on the lower left. Given these symptoms the hospital physician had her get. The scan revealed a mass in the sigmoid with metastasis. Two weeks later the patient underwent surgery to take out the mass which was 4.2 cm. The surgeon found that her cancer had spread and reached numerous organs. She commenced chemotherapy for metastatic colorectal cancer. The woman did not survive. She passed away a little over 4 months after her surgery.
The woman’s family initiated a wrongful death lawsuit against her primary care physician and gastroenterologist. The law firm that represented the family achieved a settlement in the amount of $2,000,000 on behalf of the family. The law limits the time you have to file a legal claim so if a family member died of advanced cancer and you think it was due to you should contact an attorney immediately to establish if you have a valid claim.
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