Prostate cancer affects African-American men differently from the rest of the population. Men of African-American descent are at higher risk of developing prostate cancer. As such, doctors generally recommend that African-American men should begin screening for prostate cancer earlier (the recommended age being 45) so as to increase the likelihood that if they do develop cancer it can be detected at an early stage while it is still curable. A doctor who does not follow the guidelines for a patient may be liable if it is later discovered that the patient had prostate cancer which progressed to an advanced stage because of the doctor's failure to screen the patient.
But beyond the guidelines, it may also be malpractice if a patient specifically request to be screened for a particular cancer and the doctor does not do so. Consider the reported case of a 41 year-old African-American male who had been involved in an ad campaign meant to raise awareness about the risk of prostate cancer in middle-aged males of African-American descent asked his doctor to screen him for the cancer.
The doctor performed a digital examination and found no abnormalities. The doctor ordered blood tests for the patient but did not include a request for a PSA test. The patient saw the doctor again two years later. The doctor again did not order a PSA test. This time the doctor did not even perform a digital examination.
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 lead him to believe 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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