The following case was recently tried to a defense verdict in Dauphin County, PA by members of the firm's Harrisburg Medical Malpractice team led by Attorney Andrew Foulkrod. Associate Eric Lauerman assisted in the defense as well.
Plaintiff's decedent ("Plaintiff") presented to the Defendant gastroenterologist at age 51 with symptoms consistent with both irritable bowel syndrome and colon cancer. The standard of care requires that a gastroenterologist offer a colonoscopy, beginning at age 50, for colon cancer screening; however, a colonoscopy was not offered to Plaintiff at three office visits at age 51. The following year, Plaintiff presented with a continuation of her symptoms, and also reported a family history of colon polyps as well as a change in bowel habits - both of which are 'red flags' for colon cancer. A colonoscopy was performed, but the bowel was poorly prepped, with much liquid stool throughout. Plaintiff claimed that during the colonoscopy the Defendant missed a cancer in the cecum that measured 3.5 cm at the time of diagnosis one year later.
The premise of Plaintiff's claim was that colon cancer grows slowly and would have been 2.5-3 cm at the time of colonoscopy, and that the colonoscopy should have been repeated because of the poor prep and because new symptoms of colon cancer were reported following the colonoscopy. Plaintiff claimed that the delay in diagnosis of her colon cancer increased the risk of harm and caused her death. The basis of the defense was that visualization during the colonoscopy was adequate with suctioning, and that no visible cancer was present in the cecum at the time of colonoscopy because the cancer originated in the appendix. Although no tumor mass grew in the appendix, that is consistent with a rare form of appendiceal cancer classified as goblet cell carcinoma.
Over seven days of trial, each of the parties presented experts in gastroenterology, oncology, pathology and radiology. The Defendant and his gastroenterology expert both admiitted that it was below the standard of care not to have offered a colonoscopy at the three office visits at age 51. Thus, a directed verdict was entered on the issue of negligence. However, the jury returned a verdict that the Defendant's negigence was not a factual cause of any harm. The verdict was likely premised on the defense that since the colonoscopy was negative for cecal cancer at age 52, it would have been negative at age 51, and therefore the failure to offer a colonoscopy at age 51 did not make any difference in the outcome.