A 57 year old Pennsylvania man had seen his primary care physician for 13 years, during which he complained of intermittent rectal bleeding. The patient was treated for hemorrhoids. He was ultimately diagnosed with metastatic colon cancer, underwent surgery and chemotherapy, and subsequently died. A medQuest family practitioner reported negligence in the failure to perform a yearly rectal exam once the patient turned 50. Notably, the defendant family practitioner stated in a deposition that it was not his policy to perform such preventative care, and that he had little, if any, experience with vital sign problems. A medQuest oncologist opined that had an appropriate work-up been performed before the twelfth year of treatment, the patient had a survival rate greater than 50%. Had the work-up been performed during the twelfth or thirteenth year in question, the patient still would have had a better outcome.