Statistically, men of African-American descent are at higher risk of developing prostate cancer at an earlier age than the rest of the male population. For this reason, physicians generally agree that screening for prostate cancer in men of African-American descent ought to start when they turn forty-five. By starting earlier for African-American men screening should result in diagnosing the cancer at an earlier and hopefully curable stage. When physicians fail to follow the guidelines for cancer screening and their patient is later diagnosed with advanced prostate cancer that doctor may be liable for medical malpractice.
In addition to screening for cancer, physicians also need to be able to recognize and follow up when a patient has complaints suggestive of possible cancer. Physicians also need to either perform screening testing required by a patient or make it clear to the patient that they will not perform the test and that the patient will need to see a different physician if he still wants the test. For example, in a reported case the patient was an African-American man, age 41, who requested to be tested for prostate cancer. The patient requested the screening test after participating in a campaign to raise awareness about the risk middle-aged African-American men face with respect to prostate cancer.
There are two tests generally used to screen for prostate cancer. The first is a physician examination of the prostate gland. The second is a blood test that measures the PSA level in the patient's blood stream. In keeping with the patient's request the physician conducting a physical examination of the prostate. The physician found no palpable abnormalities on the prostate. The physician then ordered blood tests. The tests, however, did not include a PSA test. The patient assumed a PSA test was ordered and simply assumed the results were normal when he did not hear anything further about it. The patient was seen again by the same physician two years later at which time the doctor did not perform a physical examination of the prostate and again did not order a PSA test.
By performing a physical examination of the prostate and ordering blood tests the physician left the patient with the impression that he had been properly screened for prostate cancer and that everything came back normal showing nothing suspicious of cancer. The patient would likely have even thought that a PSA test would have been ordered along with the rest of the blood tests ordered on the second visit. Either way, however, he certainly was justified in believing he had undergone a full screening in the earlier visit.
Move forward to later that same year. The patient returns to the same medical practice but is seen by a different physician. This time the physician not only performs a digital examination but also orders a PSA test. The result - the patient had Stage 4 prostate cancer which had spread to the bone. Even as a male of African-American descent the patient would normally not have been screened for prostate cancer earlier under the normal screening guidelines as it was only at this point that he was approaching 45. In his case, however, he had specifically requested to be screened earlier and the actions of the physician had him believing he had been.
The patient filed a lawsuit against the physician who had not ordered the PSA testing. The law firm that represented the patient reported that it took the case to train where a jury returned a verdict in the amount of $2,750,000 on behalf of the patient. The defense appealed and the parties settled for a confidential amount as the appeals was pending. Although the amount of the settlement was confidential it was less than the amount of the verdict. This is not an unusual way for both parties to reduce the risk of an adverse ruling by the Appeals Court. In this case the Appeals Court subsequently denied the appeal.
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