Alleged Misdiagnosis - Cancer Wrongful Death (Michigan)
FACTS: The estate of a patient who died from a rare form of cancer alleged the man's death was due to negligence of the man's treating podiatrist. Plaintiff claimed defendant violated the standard of care, but the jury disagreed with that argument and returned a verdict in favor of defendant.
Plaintiff's decedent, 59 year old Walter Chapton, presented to defendant podiatrist in May 2000 with a 3 cm. lump on the top of his right foot. Defendant diagnosed the lump as a ganglion cyst and was able to aspirate only a small amount of fluid from the lump. Defendant injected the lump with corticosteroids. Chapton returned to see defendant two weeks later. Defendant's notes indicated the cyst was somewhat decreased in size and he told decedent there was no need to undergo further treatment unless the cyst got bigger, became painful or changed in color. On May 17, 2001, Chapton returned to defendant as the lump had grown to 4" to 5" in length and 3" in diameter over the previous several months. Defendant recommended its removal, which was not accomplished until July 18, 2001. Pathologists identified the mass as a high-grade myxoid chondrosarcoma (cancer), for which surgery was futile as the cancer had already metastasized to Chapton's lungs. Chapton died in May 2002.
Plaintiff's experts opined that, had the cancer been diagnosed in or around May 2000, Chapton's chances of survival were 80% to 90%. However, when the diagnosis was made in July 2001, his survival chances were zero. Plaintiff alleged that, because defendant was unable to aspirate much fluid from the mass in May 2001, the standard of care required further testing, such as an MRI, ultrasound, or CT scan, or referral to an orthopedic surgeon.
Defendant contended that, despite retrospective knowledge that the diagnosis was incorrect, it was not a violation in the standard of care to miss the cancer. He claimed he was not negligent because primary cancerous lesions to the foot, , particularly chondrosarcoma, are extremely rare.
RESULT: Defense verdict
PLAINTIFF EXPERTS: Jonathan A. Haber, DPM, Caldwell, NJ, Charles F. Fenton, III, DPM, JD, Atlanta, GA, J. Sybil Biermann, MD, Ann Arbor, MI, Michael J. Kraut, MD, Southfield, MI
DEFENDANT EXPERTS: Charles G. Kissel, DPM, Warren, MI, Marshall Solomon, DPM, Farmington Hills, MI
Source; The Michigan Trial Reporter
While cancer in the foot is relatively uncommon, it is vitally important that the practitioner maintain a high index of suspicion with respect to any mass found in the foot, including the developement of a new mass or a change (color, size, depth, shape) in a pre-existing one.
Tumors and skin cancers can be found on the foot, under the nail plate (subungual) and interdigitally (between the toes).