In May 2008 a tumour-like lesion of about 1 cm is diagnosed.
Between May and August the patient undergoes review of
General Surgery, Ultrasound with benign characteristics, scarce material is obtained
(the sample is not diagnosed) , Thick Needle Biopsy is requested ( BAG), normal
NMR and no pathological solid image .
So far the performance is in accordance with protocols.
In 2009 in the review and ultrasound test the size
evolution is:
2008
June : 7 x 4 mm
2008
July : 9 mm
2009
May : 1.79 cm x 0.65 cm
There is a clear increase in nodule size and a biopsy should
be recommended, but the report says that "does not show significant
changes from previous ultrasound and no biopsy with thick needle is made".
The report of the ultrasound test does not register
significant changes in size of the node.
The latter two actions mean a delay in the biopsy prescription
of 16 months.
In August 2010 the biopsy is prescribed. The patient
delays the intervention due to her holidays considering the benign
characteristics and the long evolution.
In January 2011, following the complaint of the
patient for the delay, the nodule is removed and diagnosed as infiltrating
ductal carcinoma.
The relative probability of survival after 5 years of
the patient has decreased from 88-100 %in May 2009 to 76-86 % in February 2011.
CONCLUSIONS
There was a medical error.
It is unknown whether the nodule was a primary tumour in
May 2009 and then underwent a subsequent malignant transformation.
Should the biopsy had been prescribed in May 2009, it could
have been possible an early diagnosis and an increased life expectancy.
The defendants admitted the existence of malpractice
by, and the question left was to value the damages.
photo credit: <a href="http://www.flickr.com/photos/65882683@N03/15364097308">IMG_2617_2074x3110</a> via <a href="http://photopin.com">photopin</a> <a href="https://creativecommons.org/licenses/by-sa/2.0/">(license)</a>
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