Legal: Failure to follow up on breast mass in pregnancy

September 1, 2009

No follow up was given to a woman with lump on breast after baby is born.

In 2001 a 30-year-old Indiana woman sought prenatal care from her obstetrician. She asked her doctor to examine a lump she had noticed on her left breast and he diagnosed it as a milk gland that had swollen due to previous breastfeeding. The patient, however, told him she had not breast-fed before. After an ultrasound done several months later revealed two masses, an excisional biopsy was recommended. The obstetrician read the report and signed it, but never discussed it with the patient. The woman delivered 4 months later, and no follow-up examination or testing regarding the lump was performed during the remainder of the pregnancy. When she returned for her 6-week postpartum visit, the lump was not mentioned and the biopsy was not ordered. The patient returned to the office 8 months later and discovered that her doctor no longer worked there. She was seen by another physician and asked him to examine the lump in her breast. He concluded that it was a swollen milk gland and no follow-up testing was performed. The woman developed stomach-related issues that caused her to make frequent visits to an emergency room. Her doctor prescribed pain medication and sent her home after these episodes. Three months later, the patient underwent back surgery. The day after the operation, the patient was told that the breast lump was cancer and had spread to two tumors on her spine and three in her brain. She underwent radiation and a mastectomy and subsequently died 3 years later.

A lawsuit was filed on behalf of her estate. after a confidential settlement was reached with the second doctor and his group, the matter proceeded against the first doctor. The suit alleged negligence in the failure to order the recommended biopsy.

The physician admitted negligence but argued causation, that the death was due to the cancer and that nothing he did or failed to do affected the outcome. A jury returned a $15,000 verdict.