Summary

On May 10, 2006, Pt was seen at the medical clinic for evaluation of a growth on her left knee. Evaluation with diagnosis of “Seborrheic Keratosis Inflamed.” Pt was told the growth was non-cancerous and that there was nothing to worry about.

Procedure performed “destruction of Benign Lesion by Cryosurgery.” No biopsy or other testing was carried out to confirm that the growth was in fact “Benign.” No instructions were given for a specific follow up appointment to check on the growth.

Following the Cryosurgery on May 10, 2006, most of the growth peeled off over time, but the growth was never completely gone; it regrew. In May of 2007, the growth began bleeding so Pt returned to the clinic to have it checked. She was seen on May 29, 2007. MD surgically removed the growth and sent it for biopsy. Pt returned to the clinic on June 7, 2007 and was told by Dr that the growth which had been removed was a malignant melanoma with a Breslow score of 4.3 mm and Clark stage 4.

Pt was immediately referred for treatment. Pt was admitted to the Hospital on July 9, 2007. On July 10, 2007, a sentinel lymph node biopsy was performed. The lymph node biopsy showed no evidence of metastatic disease in the nodes.

Claim is failure to diagnose the lesion or remove the growth fully. Melanoma progressed and would have been less invasive if diagnosed sooner.

Expert Responses

Sounds like a case.Would be glad to review for causality.

Dr RB – Oncologist

This is serious negligence and the case should certainly be pursued.

Dr PG – Internal Medicine

If the melanoma was roughly in the same location as the “keratosis,” it is overwhelming likely that it was there all along. I am certain that the standard of care is that the original area in question should have been biopsied instead of ablated. At the very least, a statement that if it doesn’t disappear entirely, followup should have been undertaken. Obviously, these standards should be commented on by a dermatologist. The melanoma which was subsequently diagnosed was locallly advanced and threatening. Surely, it would have been less invasive if diagnosed earlier (and less likely to recur.) I assume that it is immunotherapy that she is receiving now. It would not necessarily have been recommeded if the melanoma was less invasive.

Dr LS – Oncologist