Over $1.4 Million Awarded to Family of Man Who Died Due to Delayed Diagnosis of Colorectal Cancer
In the summer of 2013, a male in his early forties presented to his family doctor (Dr. B) complaining of blood and mucous in his stool. Dr. B referred the man to Dr. C for a colonoscopy, which was performed in the winter of 2014.
At the time of the colonoscopy, two small polyps were removed, with another larger polyp removed in a piece meal fashion. The polyp segments retrieved were then sent to pathology. The pathology report for the polyps indicated tubular adenomas, which are precancerous polyps in the colon typically found during colonoscopies. These polyps are early warning signals for colorectal (colon) cancer.
A follow up colonoscopy was recommended in five years by Dr. C. In situations where polyps have not been completely removed, which is what occurred in this case, the standard of care is to suggest a repeat procedure in six months, rather than five years.
The man presented to hospital in the spring of 2017 complaining of a 4-week history of crampy abdominal pain preceding a bowel movement. The notes from his family doctor, Dr. B, indicated that hematochezia (the passage of fresh blood through the anus, usually in or with stools) persisted since the 2014 colonoscopy. Dr. B further noted that the man’s original symptoms persisted in addition to a 20 lb. weight loss.
A CT scan was performed in the summer of 2017, which revealed a fluid collection in the sigmoid colon and a lesion in a segment of the liver suggestive of a malignancy (tumor). The man was again seen by Dr. C a few days later and subsequently referred to a cancer centre where another colonoscopy was performed by Dr. D. The colonoscopy revealed an obstructing mass in the colon, following which a biopsy was performed detecting a high-grade adenoma, a benign noncancerous tumor.
The biopsy was unable to exclude an underlying invasive adenocarcinoma (cancer), and therefore preoperative chemotherapy and radiation therapy was ordered, followed by a planned liver resection (a surgical operation to remove part or all of the liver).
A follow up CT scan after chemotherapy revealed further enlargement of his liver metastasis (metastasis means that cancer has spread to a different part of the body part than where it started).
He was taken to the operative room in the winter of 2018 where he unfortunately died due to a complication.
Given that the man presented with a tumor three years after his original complaint and partial polyp removal in 2014, it is very likely that there was persistent tumor until 2017. Accordingly, it is also very likely that a repeat colonoscopy performed in a timely manner, as discussed in paragraph two above, would have identified the tumor at a much earlier stage than in 2017 and significantly increased his chances of survival.