Lung Cancer

[nkalisch]

I am sharing this story in hopes to find someone with good advice on the subject. My mother had been suffering from severe chest pain shortness of breath (she described it as a suffocating feeling), back pain, severe cough, weight loss and fatigue. She complained that she wasn’t able to walk half a block without feeling winded. She’d been seeing her primary doctor since March 2006 with the same reoccurring symptoms sometimes she would visit his office 2 to 3 times a month. He immediately diagnosed her as having severe allergies. Even after her symptoms worsened, he merely changed her inhaler and her allergy medications. My mother being very submissive, trusting and especially having lots of faith in our medical professionals never questioned his diagnosis. From the time that she started to see him till January 25, 2008 she became noticeably ill. She continuously used her inhaler in order to try to control her hacking cough (she was a NON SMOKER) and took so much Motrin that she started having stomach complications. We all (her children) grow every concerned, insisting that she get a second opinion. Nonetheless, she visited her doctor religiously and had faith that he knew what he was doing.

On or about October of 2007 her heath started to deteriorate dramatically and my sister who lived close by had to step in and help her with her cooking cleaning and taking her to all her appointments. As soon as my sister meet this doctor, she realized that all he did at every appointment was take vitals, change medications and send my mother home. Finally during one of her visits in early December, my sister insisted that this doctor send my mother for diagnostic imaging or refer my mother to an allergist/specialist who would be more qualified to assist my mother with these severe allergies he had diagnosed her with. As soon as the allergist examined my mother he determined that it wasn’t allergies, and immediately gave her a referral for imaging (chest x-ray). The x-rays reveled that she had developed pneumonia and they sent her back to her primary doctor. When she went to his office he assured her that the pneumonia would get better gave her medications and sent her home. She went back to him a few days later with unbearable pain and requested to be hospitalized. Her request was denied but he sent her for more x-rays which showed that she had broken ribs. He prescribed stronger pain medication and sent her home. On January 6, 2008 she was awaken early because she was not able to breath. My sister rushed her to the ER and while there, they preformed a CT scan. The scan showed a large nodule in her right lung which was also in her bone as well as in her liver. When my sister took her back to the primary doctor, he acted surprised to find this out. As a matter of fact, once my sister ordered the reports from the first two x-rays that were done, it clearly stated “suspicious nodules spotted, further imaging recommended”. The doctor pleaded ignorance and apologized to my mother. The biopsy was scheduled on the 15th of that month, he told her that she would be okay and sent her home. My mother had the procedure done and sent home the same day. On the 16th she became very ill and she went to see the doctor to advise him that she was on her way to the ER. He gave her a shot and told her she would be fine. However, my sister argued and told him that she was going straight to the hospital with or with out his permission. Once she was hospitalized the treatment started. She received one session of chemo and then the doctors said the pneumonia was to severe. They said that there were large amounts of liquid forming in the outer layers of her lungs and they would have to remove that before they started any other treatments. Once the pathologist and oncologist reviewed all scans and test they determined it was Stage 4 NSCLC Adenocarcinoma very aggressive matasized to her liver, lymph nodes, bone and head. The tumor in the lung was now blocking her esophagus blocking her airway therefore they recommended a stinting procedure. The procedure was preformed and just 2 days later, on the 25th of January, she passed away.

We are so angry at this doctor for not doing his job. As far as I’m concerned, he has murdered my mother with his incompetence and negligence. In so many words, we were told by the oncologist that my mother would have a fighting chance if it would have been diagnosed sooner (even 12 months earlier). My mother went to this doctor for almost 2 years and the only time he sent her for an x-ray was when my sister fought for it. I know that some of you might be thinking that my mother should have been more persistent with him or changed doctors. The problem with my mother was that she was to trusting and believed that the doctor was really helping her. It is a doctors responsibility and duty to help us with our health problems when we go to them… this is the role they chose when they decided to become health care professionals and in my opinion he failed her and us!

I dread this happening to another family and it possibly will or has in the past. We have been getting advise from family member and friends who tell us to first report him to the Medical Board and secondly to sue him, but we are still going through such grief we don’t know how to even pursue it. Do any of you have any advice or know of a good Medical Malpractice Attorney in the Northern California area.

Thank you for your time.
NK

[Davy9]

Your sharing of this sad episode should help others be more circumspect with their medical management. Physicians are people too and are subject to human fallacies. Whether this constitutes malpractice and to what degree would be up to the professionals to determine. The Board of Medical Quality Assurance in Sacramento is where you should report your concerns. I have no particular knowledge about any legal avenues but would think that there is no shortage of capable attorneys in the great state of California.

For whatever it is worth I am medically knowledgeable and my mother does very much as yours did despite my earnest interventions. She latched onto a cardiologist and decided that he was the one, and the only one, with all the proper answers. Though her story is nowhere near as dire it is similar.

Anytime symptoms persist or worsen while undergoing treatment further and deeper investigation is merited. By all means it is sometimes warranted to enlist a second or third clinician to be certain that all the bases are covered and that all the diagnostic avenues are explored.

You all have my sympathy.

[LungDoc]

Since my own grandfather died of lung cancer, I can certainly empathize with you and your family. Cancer is a tragic disease and it impacts far more than the person it has afflicted.

One way that may be helpful in providing closure and a sense of peace may be to ask to meet with your mother's doctor face to face and ask him/her to explain to you the reasons for his/her plans and how things unfolded. While it is always easier to pick up a phone and call a lawyer, far more may be accomplished in a shorter time with a little mediation. I would sincerely recommend you do this. I am a physician, and I have been a patient, and my parents are patients, so I see it on both sides.
Often times, there is a good rationale for why or how something was done. I have solved far more problem by sitting down with concerned families or patients, both in the hospital, or the office, this way.

Suing will not bring back you mother, nor will it quell the sense of pain and loss you have now. Once you have her doctor contacted by a lawyer, he will likely be less apt to talk with you, so now is the time. I wish you the best.

Dr. Valentino

[nkalisch]

I want to thank you for your response/advise. I would really love to speak with this doctor and ask him why he never ordered any x-rays to help pin point the problem. While reading my mothers reports, we found out that during her initial appointment it was recorded that she was taking taking 2 over the counter medications, Ibeprofen and Claritin and they were not giving her relief. By the end of 2008, she was on approx 24 different types of medications, inhalers and pain medications. I don't understand how a doctor can prescribe all of this medication without ever wondering why a patient is not getting better. It makes sense to me that a doctor would want to find the core of the problem.

Approximately 4 years ago I started to experience severe pain on my lower left back with difficulty and pain when I urinated. When my doctor examined me she determined that it was a UTI and prescribed antibiotics. During my follow-up visit a urine culture determined that there was still blood in my urine and my doctor changed my med's and ordered blood work. I followed up with her a couple of weeks later and my condition did not change therefore, she took me off the meds and ordered an IVU. The results showed several large Kidney stones that were to large to remove by Extracorporeal Shock Wave Lithotripsy so i had to have an Percutaneous Nephrolithotomy procedure. I am thankful that my doctor found the problem in a timely manner. She immediately determined that the antibiotics were not helping therefore she discontinued them and she looked more profoundly and found the core to the problem.

Not only did my mothers doctor fail to order x-rays or any other type of exams that would accurately pin point to the problem, but he also did the same to my grandmother. Both my mother and grandmother were his patients and shortly after my mother passed away, we asked that a biopsy be done on a nodule that was discovered and ruled out as scar tissue approx 12 months earlier. The biopsy determined that she also had the same type of cancer my mother had but at a stage I. My grandmother was 92 and on top of the newly found problem, she also had heart problems and was diabetic. She survived 2 rounds of radiation and while waiting for the results of a pet scan, she passed away on April 29th from a heart failure due to the radiation. On top of that, we just recently found out that a second x-ray that was done on my grandmother, showed that the nodule had grown significantly and the radiologist report recommend further imaging to rule out other complications. The doctor never mentioned this to my grandmother, my mother who was her care taker or my sister who accompanied them to their appointments.

I would love to ask this doctor why he did not order any x-rays or scans. I would love to know why he didn't mention to my grandmother that the second x-ray showed that they nodule had grown. I would like to know if all doctors make their final determination from just office visits, vitals, and I would also like to now if it's the norm to prescribe so many different types of medications to a patient. As I stated above, It took 3 visit to my doctor (which is a Kaiser (HMO) doctor) for her to order an IVP.

I would love to hear from you or anyone else who can help me understand what the norm is for a doctor as to when to refer their patients for diagnosis imaging. Should a doctor make a determination regarding a condition without any diagnostic imaging ordered? is it a doctors or patients duty to order reports and send patients to specialist. Is there a certain number of times that a patient has to be seen by a doctor without any improvements before that doctor decides to send that patient to a specialist?

After my poor little grandmother passed away, I felt sick to my stomach and numb inside because of what had happened to my mother. My grandmother was so sad and sick after my mothers death I know that she would not make it, she did not want to live anymore and told us often. I am happy that she is not suffering further and am glad that she was able to have a long 92 years of life. However, my mother was only 66 years old and we still need her so badly. Other than the "allergies" the doctor diagnosed with,she was pretty healthy and happy. There is not a day that goes by that I don't think of what happed and wonder why.

NK