Dr. V, 48, was busy. When you have your own urology practice being busy is a good thing, and Dr. V was not one to complain about long hours or a frenetic workplace. He believed that he thrived on pressure. However, being busy sometimes caused him to overlook things. In the case of one patient, overlooking something would lead to tragic consequences.

One of Dr. V’s many patients was Mr. F, a man in his early 70’s, who had periodic urinary issues and who had been referred by his primary care physician. Dr. V sent his patient for two computed tomography (CT) scans of his abdomen and pelvis, one after the patient’s first appointment and the second a year later.

When the first CT scan results were sent back to Dr. V’s office, the radiologist had noted that the patient had two enlarged lymph nodes. However, Dr. V never saw the scan. It was simply placed in the patient’s file by one of the office staff. A year later, the physician sent the patient for the second CT. This CT showed that the masses had grown from the last time, and the enlarged areas were noted by the radiologist.

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Dr. V, however, mistakenly believed that if there was anything really serious in the CT scan that the radiologist would call him on the phone. Since he never received a phone call from the radiologist, and since his office was so bustling, the CT scan results just got filed without actually being looked at by Dr. V.

Six years later, Mr. F went to the emergency department of his local hospital complaining of hip pain. A CT was performed in the hospital, and the results showed an 11 cm pelvic mass which had metastasized to the bone. Mr. F was diagnosed with advanced bladder cancer. Despite numerous courses of chemotherapy and radiation, Mr. F died within a year of diagnosis.

He left behind a distraught wife, who sought advice from a plaintiff’s attorney. Upon hearing her story, and getting a copy of the medical records, including the CT scans, the attorney eagerly took the case. Within a few weeks, Dr. V was served with papers notifying him that he was being sued for medical malpractice.

Dr. V could barely remember the case. He had not seen the patient in nearly seven years and had only seen him twice before then. But when he read the legal papers, and then reviewed the patient’s file (retrieved from archives), his heart sank. He realized he had made a terrible error.

Dr. V immediately contacted the defense attorney provided by his malpractice insurance. The attorney explained to him that the malpractice case was based on his failure to diagnose the bladder cancer.

“Why didn’t you follow up on the results of the CT scan?” the attorney asked.

“Honestly, I never actually looked at the CT scan until I was notified about the lawsuit,” Dr. V said. “I assumed that if it were serious, the radiologist would have contacted me.”

“Are you saying that you never look at scan results unless you actually get a phone call from the radiologist?” asked the lawyer, incredulous.

“No,” the physician said, “I do sometimes look at the scans. It depends on the case, on whether I suspected cancer or a blockage. I didn’t think this case involved cancer. This was more routine, for my records – and we were so busy in my office at that time…” he trailed off.

The attorney advised Dr. V against trying to blame the radiologist, saying that would only make things worse. “I strongly suggest that we settle this case before it gets to court,” the attorney said. “I don’t believe that having a jury hear this would be beneficial for you.”

Dr. V settled with the patient’s widow for $1 million, the limit of his malpractice insurance.