Do l have a malpractice complaint? Or do I just silently accept this?
January 25, 2017 6:52 PM   Subscribe

My mother is dying of brain cancer. Back in September, after a series of tests for long standing back problems, xRays revealed lung lesions which of course were biopsied twice. Both biopsies were negative and the second tests said the lesions were smaller. So happy Thanksgiving and Christmas.

December 30 I took her to the ER as she was having rightsided blindness and other neurological symptoms which everyone concluded was a small stroke. They sent us home with recommendations to take aspirin. Referral for OT and PT.

Three weeks later, another trip to a different hospital, another ct Scan revealed 2 quite large brain tumors.

The thing which outrages me is her regular doctor reviewed the findings from the first visit and went along with the er diagnosis of stroke. Mom's oncologist, who was fairly diligent about things was dumbfounded by the lung lesions shrinking and even more shocked by the new scan. She was not receiving any cancer treatment of any kind, but her oncologist wanted another lung ct in February just to be safe.

Her regular doctor apparently never read any of what has gone on and when I spoke with him today was mildly and minimally apologetic. Meanwhile I have hospice coming so we sit and cry waiting for a nurse who only has limited knowledge of all my mom's previous problems.

It's the disinterest of her regular doctor and his office which really gets to me. She has been going to him for at least ten years. And my Mom feels utterly betrayed by the whole ordeal. In advance, thanks for any advice about watching my mom dying and making the best of it.
posted by BarcelonaRed to Law & Government (17 answers total) 5 users marked this as a favorite
I'm very sorry for your mom's situation.

IANAL, and I'm not a doctor, either, but I worked at a malpractice law firm for about nine years. Some things that you would want to look at are the standards of care for the symptoms your mom had back in September. If she wasn't exhibiting any symptoms then of brain tumors, it would depend on I think, what doctors normally look at when someone presents with lung lesions.

As for the delay between December 30 and now, I'd look at if the doctors paid enough attention to your mom's history of the lesions, etc. However, if the outcome/treatment between the treatment your mom was going to get on December 30th isn't a lot difference than the outcome today, I'm not sure there's a claim.

Get her medical records and have a lawyer do a free consult.
posted by roomthreeseventeen at 7:11 PM on January 25, 2017 [4 favorites]

The one gap in your description is what kind of imaging, such as CT or MRI, was done on December 30 to support the diagnosis of stroke. You would think that that imaging would disclose the tumor.

But it has not been more than a few weeks. One of the realities of dealing with cancer claims is that the tumors take a long time to develop to the point where the diagnosis can be made.

If they are regarded as inoperable now due to size, that very well may have been the case then as well.
posted by yclipse at 7:25 PM on January 25, 2017 [1 favorite]

The imaging on the 30th was ct scan. She also had a PET scan in early October.

They even thought the brain lesion was from a stroke at least two weeks old. I guess it just seems they weren't too aggressive about the findings from the PET scan. It sort of feels like she's just too old to bother. (86)
posted by BarcelonaRed at 7:52 PM on January 25, 2017

I'm very sorry you and your family are going through this. My mom's osteosarcoma was initially diagnosed as a rheumatoid arthritis flareup. It wasn't.

Think hard (and talk to your close family) about what you want out of this. You can't go back in time and change what happened; given that, do you want: doctor(s) to lose their license? To get money (for care, for medical debts, etc.)? For the doctor(s) who fucked up to apologize? Pretend for a second that the process has gotten to the point where the malpractice insurance company is offering a settlement but no admission of wrongdoing. How do you feel? What is it that you want, and can a malpractice suit give you that, or something approximating that?

(To be clear, I'm not categorically against suing, or researching suing, but...yeah, think about what you really want the outcome to be.)
posted by rtha at 9:13 PM on January 25, 2017 [20 favorites]

I'm so sorry that you're going through this. I can't imagine how difficult this is for you, your mother, and your family.

It seems as though this was not handled with the utmost tact and compassion from your mother's PCP. It's possible that your mother's doctor didn't do a thorough job. However, I urge you to spend time with your mother and to not jump to a malpractice lawsuit right this moment. Your mother's doctor is only human and likely deals with this day in and out. Yes, it's their responsibility to be thorough and compassionate, but they're likely just doing their best in an imperfect system. Your mother is sick and dying and perhaps didn't receive the best care that she deserved but I'm of the opinion that a doctor shouldn't be sued because of it.

Give it some time and collect the information. If it becomes clear in time that your mother's doctor was grossly negligent then perhaps this is the path forward. However I recommend you focus your attention on your mother and enjoying the time left together instead.
posted by masters2010 at 9:17 PM on January 25, 2017 [1 favorite]

Care for your mother first, destroy those who wronged her second. If that means (I'm sorry) post-mortem, then so be it. She's more important than your sense of justice.

But, when the time comes to destroy them -- this is why they have insurance, so you should pursue every available avenue to make them pay. This is the system we have in the US, you may as well work it to your benefit. They're trying to work it for their benefit, why should you be the sucker?

Get the medical records, get a free consult from a well-reviewed lawyer, and weigh your options, keeping in mind that right or wrong have no meaning in the modern US medical system it's just a question of who can win.

You wil get people telling you to let bygones be bygones. Ask them to pay for the medical bills.
posted by aramaic at 9:56 PM on January 25, 2017 [5 favorites]

Could you clarify what the lung lesions have to do with your mom's care? If I am reading your story correctly, these lesions are benign? If so, then they are not relevant to the brain cancer diagnosis? Is that correct? Or when you say that your oncologist was "dumbfounded" by the lung lesions, are you saying that they turned out to be malignant despite the earlier negative biopsy results?
posted by Seymour Zamboni at 5:25 AM on January 26, 2017 [1 favorite]

> It sort of feels like she's just too old to bother. (86)

When this type of diagnosis arises in a person of that age, especially if there are “co-morbidities” - i.e., other illnesses or chronic conditions - physicians often gravitate toward recommending palliative care rather than aggressive surgical treatment. A doctor who is better at communicating would be able to make this point, and the reasoning, to her and to you, but also would be able to emphasize that the choice is hers and that second opinions are always available.
posted by yclipse at 6:04 AM on January 26, 2017 [4 favorites]

No, I don't think you have a malpractice complaint. It seems like your mother has been in good health and this is a shocker so you are looking for someone to blame. Blame age. I'm sorry that this is blunt. You asked if you have a malpractice complaint and I really think that you do not.
posted by pintapicasso at 7:10 AM on January 26, 2017 [3 favorites]

I am so very sorry you are dealing with this. I agree with the others that it is most important to focus your time and your energy right now on your mother and ensuring you are making the most of your time together. The rest can wait.

The question about what you want to get out of this is a good one and one to hold onto for the future. If I were in your shoes, I would want that PCP to understand very deeply the pain their approach caused. I read an article recently, written by a young woman who had her health concerns written off by her PCP. She later, after her treatment was complete, wrote a letter to that PCP and demanded a face to face meeting to talk about it. She was able to look them in the eye and lay out the pain, fear, confusion and suffering they had caused her. It wasn't a perfect solution, but that physician will have that meeting in their mind first and foremost every time they meet with a patient from then on. I wonder if this might be an approach for you?

I wish your family comfort and peace.
posted by goggie at 7:13 AM on January 26, 2017 [1 favorite]

I'm sorry you're going through this. My Dad died of brain cancer at 63. His initial symptoms were much the same as your mother's.

During his treatment, there were so many doctors and visits in play that communication between all the parties wasn't at all what we expected. Things worked best once we took on the role of his primary record keepers, providing written records of latest-steps everywhere we went.

But all of those mis- or non-communications, did that mean that anyone was negligent? Maybe, maybe not. It was hard enough for us to keep track of, and we were only looking after one patient.

Malpractice is a very tough standard to reach, and doctors' lawyers are the best of the best. Go see a lawyer for your own peace of mind, but be prepared for any answer they may give.

Care for your mother first, destroy those who wronged her second. -- absolutely this.

I am sorry you are all going through this. Believe me, I know.
posted by Capt. Renault at 7:22 AM on January 26, 2017 [1 favorite]

The biggest mistake I made when my brother was dying of cancer was that I was so focused on his potential death that I was unable to make the most of the time he had left. That was thirty years ago, and I regret it to this day.

I was diagnosed with an incurable cancer in September. Over the course of the previous year, four doctors missed it (it would have been easy to see something was very wrong with a routine blood test - but nobody thought to do it until I finally sought out a holistic doctor, who ran the blood test, then called me that night and told me to get myself to the ER). One doctor had me do a stress test, which I later found out could have killed me. I feel that I was profiled as a potential cardiac patient because of my age and weight. What does your mother want? The best thing you can do is to support her emotional and physical needs. I would not want my children to be focused on a possible malpractice suit at this time, and I would still have incurable cancer even if it was found a year earlier. It is very hard to prove malpractice. (I do not mean to imply in any way that you are not focusing on caring for your mother.)

I am very sorry you are going through this, and I wish you and your mother the best.
posted by FencingGal at 7:32 AM on January 26, 2017 [4 favorites]

IAAL, IANYL. If you came to me for a consult, I would echo more or less what pintapicasso said. Malpractice claims are extremely difficult to pursue successfully, and this one sounds like it would be more difficult than many given your mother's age and previous health problems. Even if you were to win a judgment (and to be frank, that's unlikely), damages would probably be pretty minimal given you mother's age. You can consult with a plaintiff's malpractice lawyer, but my guess would be that it would be very difficult to find any lawyer willing to take this one on.

I'm very sorry that this is happening.
posted by holborne at 8:18 AM on January 26, 2017 [2 favorites]

I'm very sorry this happened.

Not a lawyer or a doctor but in the case that a malpractice suit is untenable, but there is evidence of inadequate care, you could try filing a complaint with your state's medical licensing board.

At least this might leave a paper trail that could be helpful for any other patients should this doctor come under scrutiny again in the future.
posted by forkisbetter at 2:27 PM on January 26, 2017 [1 favorite]

I'm sorry your mother is ill and that you felt her primary care doctor was not responsive to your concerns.

It's a little unclear exactly what you mean by her doctor "never read[ing] any of what has gone on." Was the PET scan from October abnormal?

It sounds like she had a CT scan that was read as a stroke by the hospital radiologist on 12/30 and then another scan a few weeks later that showed clear tumors? It's not tremendously surprising that her doctor went along with the diagnosis of stroke if that's what a trained radiologist thought it was. 86 year olds have small strokes pretty frequently, and cancer patients are even more likely to have strokes. And brain tumors can enlarge surprisingly quickly at times.

If you have concerns that the standard of care was not met, you can certainly meet with a malpractice attorney, but it sounds like there was not much of a delay in diagnosis (3 weeks) and that it's unlikely that treatment would have been much different if it had been picked up with the first scan. But if you're worried, do have someone go over the facts of your specific case.
posted by The Elusive Architeuthis at 4:38 PM on January 26, 2017 [1 favorite]

While I for the most part agree with the people who urge you to focus on what your mother wants you to be focusing on, which is probably not litigation at this point, you should be aware that the statute of limitations for bringing a claim of medical malpractice is fairly short in some states--as short as one year--and, at best, the clock began running this month. I don't know how much time your mother has left, and I doubt that in the immediate aftermath of her death you will be in a good state for filing lawsuits. So you might want to consult with a lawyer now just to get a clear idea of when you will have to act, in case you decide to do want to act.
posted by praemunire at 8:06 PM on January 26, 2017 [1 favorite]

Today my mother cried and cried because she cannot understand why she has brain cancer but not lung cancer after we literally spent two months of tests and a trip to Augusta to see the only thoracic surgeon around. (120 miles)

The thoracic surgeon was pretty confident that she had lung cancer and the PET Scan showed other spots which were questionable. So we have a mystery. The oncologist declared no problem and her regular pcp offered no plans for follow-ups on anything.

Every time today, when I brought her another course in her hospice care drug program she cries and asks isn't there anything we can do? Aren't we going to the oncologist? Or the other Worthless prick?

When I picked her up off the floor, after she lost her balance and scraped her back while I helped her use the commode; I remembered the times when I told Dr. Worthless about the right side blindness and her cough which he attributes to a swallowing problem. And the persistent upper back pain which is probably bone mets. Was that the start of the brain tumors then? And now I am wondering if this was a slow growing tumor that has become so large we can't do anything.

And lastly, I have a dark thought that both of the doctors knew she had some late stage cancer and didn't want to try anything because of her age. I have been with her almost constantly and am currently sleeping on the floor so I can hear her if she tries to get up and crashes because of the rightside weaknesses and blindness.

So what will I do? I will stay with her as I have left my job and hospice my own mother. Dr. Worthless better hold on to his hat because I am going to take him to the wood shed when this is done. I'll be very busy listening to my mother die and this will undoubtedly fuel my pitbull-like urges for retribution. I will have plenty of time to plot while we kill her with morphine and tranquilizers. Every time she looks at me in agony I will remember Dr Worthless's empty and meaningless explanation.

Pintopicasso, mom wasn't fine before all this-- I took her to pain clinics, and neurologists and therapists searching for the sources of her problems. I think we can all conclude there was something more than a herniated disk.

Thank Aramaic. My next question will most likely be about getting all her ten years records of persistent lameness and neuropathy before the bastard gets to edit them.
posted by BarcelonaRed at 5:50 PM on January 28, 2017

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