Washington DC Metro Medical Malpractice Lawyer Blog

If you have been following our blogs and case summaries on our injury website, you can see the many negligence cases in which we have successfully tried or settled for women or their grieving families regarding breast cancer. Over the years we have had clients, through breast self-exam (BSE), find unusual signs and symptoms such as dimpling, puckering or bulging, swelling, discoloration, or soreness, saw their physician and yet the healthcare provider did not think a mammogram at that time was warranted. We have had cases where the radiologist misdiagnosed the mammogram or did not suggest a follow-up sonogram. The patient did everything correctly, but it was not caught early enough to spare their life.

Although there is some thought now that BSE causes unnecessary biopsies and surgery on some individuals (men do get breast cancer, too), it is especially important to be vigilant and contact your doctor if you notice any of the signs and symptoms mentioned above. In addition, if your breasts are dense, you can lower your risk by exercising, eating properly, and maintaining an optimal weight, and reduce or abstain from alcohol (all types) and smoking. Age plays a factor as well. If you menstruated before age 12 or are over age 55, your risk increases for getting breast cancer. Finally, if you have close relatives, especially a sister, mother, or daughter who have breast cancer, your risk is higher than someone who does not have a family history of breast cancer. Make sure when you see your physician or gynecologist that you mention this fact during your examination, as not all physicians will review your entire file before your examination.

By Laurie Amell, Esq. and Sandra L. Thayer, Legal Assistant

April is Oral Cancer Awareness Month. It has been appropriately publicized that dentists play a critical role in detecting oral cancer. Many dentists perform oral cancer screenings as a part of their standard practice. It is important to make sure that you receive regular oral cancer screenings from your dentist, whether or not that is a standard part of the dentist's examination.

The majority of sores, lumps and bumps that appear in the mouth are not cancerous and disappear on their own after a short time. If a lump persists, a dentist should not reassure you that the lump is benign if it has not been biopsied. It is not necessarily evident without microscopic examination whether a lump has cancerous potential.

We recently handled a case where a patient went to her regular dentist for a routine cleaning appointment and pointed out to him a lump in her mouth that had been present for several weeks. Her dentist examined the lump, reassured her that it was nothing to worry about, and said nothing about monitoring or follow-up. The lump persisted in her mouth, but did not noticeably increase in size and did not otherwise bother her, and having been reassured that it was nothing to worry about, the patient did not bring the lump to any dentist's or physician's further attention. It was not until an ENT doctor treating her for sinus concerns looked in her mouth and saw the lump that she was told that the lump should be biopsied, and shortly thereafter found out that it was a form of carcinoma.

A patient does not have to second-guess a trusted physician's instructions, and the law says that the exercise of reasonable care does not require a patient to obtain a second opinion in a case like this. Dentists and physicians do make errors, however, and sometimes those errors have life-threatening consequences. A mouth lump that persists, like a sore that does not heal, is suspicious. If a mouth lump does not go away on its own after a reasonable period of time, it should be reevaluated.

The National Cancer Institute at the National Institutes of Health in Bethesda, Maryland provides additional information about oral cancer on their website.

It is well-known and generally accepted that skin cancers and melanomas originate in people who have longstanding exposure to sun rays, especially in sea-goers who don't use appropriate body cover and/or protective sunscreens.

When a patient has had significant exposure during their childhood and beyond, and especially in patients with a family history of skin cancer, total body examination by a dermatologist, even on a yearly basis, may be important. In patients who have had any type of skin cancer, it is mandatory to keep them under surveillance, at least in the first 5 years post detection and surgical resection of skin cancer. The reason for this standard is that following skin cancer detection in patients, the likelihood of detecting a second cancer greatly increases as compared to the rate in the general population.

The most common skin cancer is basal cell carcinoma, which is relatively benign even though in sensitive skin areas like the skull and face it can cause serious penetration into the bone and even into the brain if not detected and excised in a timely way.

Squamous cell carcinomas are more aggressive than basal cell carcinoma and can lead to spread of cancer cells systemically and lead to life-threatening metastatic cancer with a poor prognosis and limited therapeutic treatment modalities.

The most feared cancer of the skin is melanoma, which if it has metastasized is a deadly disease that cannot be cured. The only chance the patient has is early detection and early removal of a melanoma lesion.

We represented a 50-year-old man who had several basal cell carcinomas which were removed by excision. However, his physician neglected to properly follow the patient. As a result, a melanoma was not timely detected, and this melanoma spread systemically in all the patient's organs. Unfortunately this young husband and father died, leaving a widow and young children behind who depended so much on him. Our team successfully represented the family, and the case resolved prior to trial.

We have a team of medical professionals on staff that work with the highly successful medical malpractice attorneys at Stein, Mitchell, and Muse, LLPto prepare your case for trial. If you or a loved one have been the victim of medical malpractice, give our team a call at 202-737-7777 for a free consultation.

Acute Lymphoblastic Leukemia (ALL) is probably the most frequent type of leukemia in children age ten and under. As with all forms of cancer, it is imperative that treatment begins immediately, especially as this disease progresses to a life-threatening point extremely quickly, sometimes in as little as a few weeks. Symptoms mimic many other possible diseases including flu and cold, thus ALL is usually not considered until a complete medical history has been obtained from the parents, and the child has undergone blood work with medical examination by a pediatrician.

White blood cells are needed to fight infection, but in someone with ALL the body produces abnormal versions of these cells, which tend to duplicate quickly and crowd out the red blood cells that are necessary to carry oxygen and carbon dioxide to and from tissues in the body, causing organs to shut down.

ALL's rapid progression is one distinction from "chronic" lymphoblastic leukemia and can be present for many years. Testing such as complete blood count, liver enzyme tests and several others can confirm or rule out ALL. Symptoms include weakness, fatigue, frequent fevers, weight loss, loss of appetite, bruising, joint pain, breathlessness, swelling in lower limbs, and tiny red spots or lines in the skin due to low platelet counts. The exact cause of ALL is unknown, but it is likely from damage inflicted to DNA, possibly by chemicals, drugs or radiation in our environment.

We know the gravity of cancer. Even as adults, we are frightened when we or our loved ones are given the diagnosis. For many, the difficult fight against the disease now feels impossible as the worsening economy leaves us without health insurance; a growing number unable to seek medical attention when we suspect that something is wrong, powerless to get help at the crucial point when cancer is in its early stage.

But more devastating is when we discover that our children's symptoms we thought were from a lingering flu or cold, are signs of cancer. Most of us don't even consider that infants and children can develop the disease. Worse still is the startling reality that symptoms like breathing difficulties, inability to crawl or stand, swelling, weight loss, and bruising may even lead some physicians to suspect child abuse, dangerously delaying a proper diagnosis and hurtling parents into a nightmarish battle to prove their innocence - all the while being terrified for the wellbeing of their child.

Knowing if your child's symptoms are signs of cancer can prevent this situation and help you get appropriate treatment faster. In this series we will explore the different types of cancers found in children, and the signs and symptoms to watch for.

Laurie A. Amell is a nurse and a medical malpractice attorney who practices in Washington, D.C., Maryland, and Virginia. Stein, Mitchell, and Muse, LLP has a team of three nurses, an in-house physician, and expert attorneys specializing in medical malpractice who are available to consult with you regarding a potential case. Call us at 202-737-7777 for a free consultation.

Endoscopists using the water-infusion method of screening colonoscopy found significantly more adenomas if they added indigo dye, compared with the water method alone, a new study has shown. "Indigo carmine enhances any surface irregularities" when used as part of screening colonoscopies, Dr. Joseph W. Leung said in a late-breaking abstract session at the annual meeting of the American College of Gastroenterology.

Indigo carmine is used to enhance adenoma (polyp) detection in chromo-endoscopy, which is a more cumbersome process than the water method, Dr. Leung said. He and his colleagues at the Sacramento VA Medical Center in Mather, California conducted a randomized, controlled trial to assess the value of adding indigo carmine to the water method. The colonoscopies were performed by two endoscopists who had experience with both methods. Patients were blinded as to which procedure they had, and all patients underwent intravenous conscious sedation. In both groups, air was suctioned out of the rectum to remove any fecal material and stool or cloudiness was suctioned out, followed by another infusion of clear water. Apparently colon preparation and surface enhancing play an important role in adenoma detection.

Early detection of a polyp is critical because polyps evolve to cancer over time, and if not resected can metastasize and result in death. Colonoscopy evaluations have a low but significant false negative rate, and repeat colonoscopies may sometimes detect undiagnosed but pre-existing adenomas. In high risk patients or symptomatic patients, however, a single colonoscopy may be the only chance to detect an adenoma before it becomes cancerous. Therefore, when doing a colonoscopy it is important to utilize the best available technique to detect these potentially lethal abnormalities. A patient can ask the physicians performing the study how they plan to do the study and how that method enhances detection. Failure to detect may be based on failure to adhere to available guidelines or using outmoded techniques.

Stein, Mitchell, and Muse, LLP has successfully handled numerous cases of undiagnosed cancer following failed colonoscopy procedures. Our experienced medical malpractice team is available at (202) 737-7777 for a free, no obligation consultation.

Brain tumors, or intracranial neoplasms, can be a particularly devastating form of cancer. While these tumors are not always malignant or fatal, a patient's prognosis depends heavily on their size, location, and early detection. But such detection is unfortunately difficult, as changes are masked by the skull and pain is usually absent due to the lack of sensory nerves within the brain. Symptoms are often delayed until the late stages of disease, when increased intracranial pressure can begin to damage the brain's structure. Even this is dependent upon the particular form of the tumor, and prompt imaging should be obtained to recognize the potential harm wrought by brain tumors.

A malignant brain tumor can be primary, originating in the brain, but the vast majority are secondary tumors resulting from late-stage, metastasized cancer in another organ which has spread to the brain through the lymphatic system and bloodstream. Benign brain tumors are still serious and can be life-threatening. Because the brain is enclosed within the skull, the growth of even a small tumor can cause severe and permanent damage through increased pressure exerted on the brain.

Certain brain cancers like Medulloblastoma and Oligodendroglioma have good median survival rates, while Glioblastoma multiforme, the most common form of brain malignancy, is also the deadliest. Treatment options are dependent on the form and severity of the brain cancer, but typically include the use of surgical excision, radiation, and chemotherapy.

It is important for both doctors and patients to be aware of brain tumor symptoms that are often overlooked or mistaken for another condition. These include headaches or migraines without prior history, especially in patients 50 or older, or in children under 6. Additionally, neck stiffness, increased intracranial pressure, behavioral or consciousness changes, neurological dysfunction, and vomiting not caused by other illness or headache can be indicative of a brain tumor. If these symptoms are present, and other conditions are ruled out, doctors should immediately perform an MRI or other high-resolution imaging procedure to ensure that a tumor is not the cause.

We have handled cases of undiagnosed brain tumors. If you or a loved one has been misdiagnosed and suffered injuries as a result of suspected malpractice, please contact any of our qualified medical negligence attorneys at Stein, Mitchell, and Muse, LLP.
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See part one
See part two

If you are around the age of 50 or have a family history of colon cancer, chances are that your physician will instruct you to schedule a colonoscopy. Many of us have heard others talk about the dreaded "prep" they must endure the night before the procedure. True, it's not a particularly pleasant experience, but it is a very important diagnostic tool for catching colon cancer in its initial stage, thus saving your life. This type of cancer is slow-growing, which is why the colonoscopy is repeated every five years. However, there are instances where the physician will instruct the patient to return more frequently. It is important to be mindful of when you are due for your next colonoscopy,

On the day of the procedure, after emptying your colon the night before (usually by drinking a special solution ordered by your physician), you will be lightly sedated. During this 20-30 minute procedure, the physician inserts a flexible thin tube (with a light and tiny camera) and examines the entire colon, as well as the lower part of the small intestine. The doctor will be looking for polyps (a mass or growth of tissue), as well as an explanation for any complaints of bloody stools, rectal bleeding, and chronic diarrhea, among other concerns or complaints. If polyps are present, they are removed since some eventually develop into cancer.

One tragic colon cancer case can be found on our website under "Settlement in Colonoscopy Cancer Case," where we alleged that the physician's negligence included, among other things, that the colonoscopy was performed in 10 minutes, a time which we contended was far too fast to properly visualize the colon.

See part one

Have you ever wondered why your physician always feels your neck when you are seen in the office? Your doctor is checking for abnormalities such as nodules.

Thyroid cancer is a neoplasm (a tumor or tissue containing a growth) that is malignant. A mass in the thyroid region of the neck, swelling in the neck, difficulty swallowing, and hoarseness are initial symptoms that can lead to the discovery of nodules. Many of us have nodules on our thyroids, but 95% of these tumors are not malignant. Benign tumors are, however, worrisome in patients under 20 years of age, as the potential is far greater that they will become malignant. Sixty years ago, young children were subjected to low-dose radiation to the head and neck to treat numerous types of diseases. This predisposed people to developing thyroid cancer, especially if they were very young at the time of exposure.

Once a nodule is discovered, the patient should be referred to an otolaryngologist or endocrinologist for further evaluation. This specialist will perform an examination and hopefully order a sonogram to ascertain the size of the nodule. If the nodule is larger than 1.5 cm, a fine needle aspiration would be performed by another specialist, often a cytopathologist. A needle is inserted through the neck area into the mass so that tissue samples can be obtained and viewed under a microscope to rule out malignancy. Although this sounds frightening, it is actually not painful and no medication is given during the procedure.

The prognosis depends on the type of cancer and the stage (the extent that the cancer has spread) when diagnosed. Papillary, the most common form of thyroid cancer, has an excellent prognosis. Early diagnosis is important before the cancer spreads beyond the thyroid gland, thus increasing the odds for a better outcome. It should also be mentioned that many small nodules never grow or metastasize. However, repeating the biopsy once a year will probably be recommended.

We have successfully handled hundreds of undiagnosed cancer cases that physicians and radiologists failed to diagnose and their patients did not survive, or they live with the fear that their cancer will take their life at any moment. If you or someone that you care about would like to discuss your situation with Ms. Amell or another experienced medical malpractice attorney in our firm, please contact us to arrange for a free consultation.

Ms. Amellis a nurse and an attorney licensed in the District of Columbia, Maryland, and Virginia.

Our next series will be on different types of malignant neoplasms, better known as cancer (where a group of cells invades and destroys adjacent tissues). These cells metastasize (spread to other parts of the body), and travel through the lymphatic system or bloodstream to the brain, bone, and other organs. Most cancers are treatable if caught early. However, if your healthcare provider ignores your early symptoms and concerns, and additional time is allowed to lapse, your prognosis can potentially go from a curable stage to one with a poor prognosis.

We will be covering common types of cancer in the coming weeks, such as breast cancer, brain tumors, colon cancer, malignant melanoma, cervical cancer, ovarian cancer, thyroid cancer, and other types of this frightening disease, and discussing cases which we have handled for our clients and their families.