Carcinoma of the cervix is one of the most common malignancies in women, accounting for 15,700 new cases (6 percent of all cancers) and 4,900 deaths in the United States each year. Worldwide, cervical cancer is second only to breast cancer as the most common malignancy in both incidence and mortality. More than 471,000 new cases are diagnosed each year. During the last 50 years in the United States, the utilization of screening programs based on the Papanicolaou (Pap) smear and pelvic examination has led to a steep decline in incidence and deaths from cervical cancer.
Prevalence of cervical cancer is highest among Hispanic women, followed by African American women and white women. Human papillomavirus (HPV) is a major risk factor for cervical cancer. Over 6 million new HPV infections in men and women are reported each year in the US, with 10% of infections in women leading to persistent dysplasia or cervical cancer.
Maryland, thankfully, has a comparatively low cervical cancer death rate. But the numbers are still too high and too many Maryland doctors miss cervical cancer at a stage where the patients could still be cured.
If you believe you have a potential malpractice claim call 800-553-8082 or get a free online consultation here.Why a Missed Cervical Cancer Diagnosis Results in a Lawsuit
There are a lot of medical negligence suits involving cervical cancer for a simple reason: survival rate depends critically on early diagnosis. Women diagnosed early by their doctors generally have good outcomes. Early stage diagnosis has a 5-year survival rate of 80-90%. If cervical cancer is missed – either through malpractice, a defective test, or the symptoms were not noticed or recognized by the patient - survival rates decline. Stage II, III and IV cancer with the latter having only a 15% 5-year survival rate. Stating the obvious that goes with every cancer: an early and accurate detection is key to the best prognosis and mental and emotional well-being of women.Cervical Cancer Testing and Prevention
The Papanicolaou test (also known as Pap test or Pap smear) has been accredited to the significant decrease in cervical cancer deaths in the past 40 years. Before Pap tests, cervical cancer was responsible for the highest mortality rate among cancers affecting women. The annual direct costs of cervical cancer in the U.S. was estimated to be $6 billion before the introduction of the HPV vaccine (which has generated a lot of new interest of late in the Republican debates).
Pap tests screen for cell changes on the cervix or pre-cancers, which can give women a huge head start in knowing whether they are at risk. According to The American College of Obstetricians and Gynecologists, women are recommended to be screened every two years from age 21 to 30 and every three years thereafter, provided their last three tests were normal, until the age of 60 or 70 at which time, based on the patient's history, tests may be no longer be necessary. Approximately 55 million Pap tests are performed annually in the US. Approximately 3.5 million tests are abnormal.
Pap tests are not a diagnostic test. But they are used to identify the presence of abnormal cells. Diagnostic tests include colposcopy (a scope which is used to look at the cervix), biopsy, endocervical scraping, and cone biopsy. If diagnostic tests are not performed, effective treatment options may be delayed.How Inaccurate Tests Can Make Matters Worse
Some cases that appear to be cervical cancer misdiagnosis cases are actually due to defective testing. This may be an unpreventable false negative or negligence on the part of the testing facility. Naturally, inaccurate test results – false negatives and false positives - can lead to anxiety and affect the overall health of a patient. But, of the two, false negatives are of greater concern. False positive tests are usually due to the presence of squamous intraepithelial lesions. A false positive test will require the woman to undergo further testing, possible biopsy and can result in undue pain and anxiety for the patient. It is estimated that false negative tests occur 5-50% of the time, 80% of these are true false-negatives, and 20% are due to laboratory error.
The accuracy of Pap tests can be diminished by several factors. They include incorrect timing of the test (should be conducted 10 to 20 days following a woman's last menstrual period to avoid blood in the sample), douching, and vaginal medicines and spermicides, used within 2 days of the test. The problem is these can wash away or hide abnormal cells. There are also clinician factors such as the incomplete or inaccurate capture of medical history and risk factors such as HPV, improper storage of slides, incorrect or unlabeled slides, inadequate sampling, performing the test in presence of an infection. Accuracy can also be compromised by laboratory factors (misinterpretation or failure to identify cell type and poorly controlled technical process). Further lesions can be missed if they are small, invasive, or deep in the cervical canal.A Lawyer for Your Failure to Diagnose Cervical Cancer Claims
Missed cancer diagnosis cases in Maryland are very painful for the victims and their families. If you or someone you love has suffered as the result of a medical misdiagnosis, call Miller & Zois at 800-553-8082 or get a free no-obligation medical misdiagnosis consultation.Verdicts and Settlements in Cervical Cancer Lawsuits
- 2016, Illinois: $2,500,000 Settlement. A 79-year-old woman goes to the ER after a fall while at church. She is admitted to the ER and is treated for soft tissue injuries. An X-ray of her chest is done and she is discharged home. One and a half years later, she has a severe cough and she returns to the ER. The doctor determines that her coughing symptoms are caused by a mass in her right lung, which has grown since her last chest X-ray during her visit for a fall. The woman is diagnosed with Stage IV lung cancer that has spread to her lymph nodes. She does not respond to aggressive treatments and passes away from lung cancer. Her Estate alleges that the mass should have been communicated to the woman at the time it was detected during her emergency room visit, and that if it had been, the woman’s life expectancy would have been ten more years. The defendants argue that if the cancer was diagnosed earlier, aggressive treatments would be required which would have negatively impacted her quality of life. The hospital settles the case for $2,500,000.
- 2016, Virginia: $1,301,646 Verdict. A 77-year-old man has a chest X-ray done. It is interpreted as abnormal. A second X-ray is done without the reading of the first image and is read as normal. A year later, the man is diagnosed with lung cancer that has spread to his brain. He dies a few months later of lung cancer. His wife files this claim, alleging that the defendants failed to properly interpret the images and failed to compare the studies. A jury awarded the man’s estate $1,301,646.
- 2016, Pennsylvania: $1,100,000 Settlement. A woman goes to the hospital with lightheadedness, nausea, vomiting, and high blood pressure. A chest X-ray is part of the diagnostic tests ordered. The woman is discharged without being informed of the results of her chest X-ray, despite a small abnormality detected in her lung. Two months later, she begins to have trouble speaking and controlling her hand movements. She is taken to the hospital, where a chest X-ray is done. This time, the radiologist interprets it as a mass, with likely metastasis to her left lung. It is determined that the cancer involves brain metastasis. The woman dies from complications of the lung cancer a few years later. Her Estate claims that the defendants were negligent in failing to review the chest X-ray and in failing to diagnose the woman with lung cancer when she had a better chance of responding to treatment. The parties settled, with the hospital paying $100,000 and the defendant radiologist paying $1,000,000.
- 2016, Florida: $4,000,000 Verdict. A 59-year-old woman has a Pap smear done to test for cervical cancer, and the results are negative. Two years later, she goes to her gynecologist with bleeding. A pelvic exam and ultrasound are normal. A few months later she returns, with pelvic pain and continued bleeding. A cervical biopsy is done, and it shows a poor-differentiated adenocarcinoma (a quick-growing cancer) with serous papillary features (endometrial cancer). The woman is referred to a gynecologic oncologist who finds cancer in her uterus. Despite chemotherapy and radiation treatments, the woman passes away. Her estate alleges that defendant misread the pap smear and failed to detect the woman's cancer. Defendants argue that the cancer was aggressive and not present in the pap smear. A jury awarded the woman's estate $4,000,000. Defendant filed several post-trial motions, including motions for mistrial and a new trial. These motions are still pending.
- 2015, Maine:$9,636,000 Verdict. A 59-year-old woman has four pap smear tests done over the course of two years. Each time, defendant technician examines the samples. After the four pap smears, the woman is diagnosed with Stage IIIB cervical cancer. She begins chemotherapy. She and husband bring a claim against the technician, alleging the misreading of four tests and the failure to diagnose cancer. Defendants argue there were no clear signs of cancer, but the jury found that the defendant committed malpractice and awarded the woman $9,636,000.
- 2014, Florida:$15,800,000 Verdict. A 37-year-old woman has a Pap smear which she alleges is misread. It is not until two years later, when a different OB/GYN detects a mass, that the woman is diagnosed with cervical cancer. Unfortunately, the woman dies eight months after the diagnosis. Her estate alleges that the cancer should have been diagnosed when it was still treatable and that they should have done an interim pap smear. A jury found that the defendant was 75% negligent, while the plaintiff was 25% negligent. They awarded her $15,800,000.
- 2013, Washington: $1,000,000 Settlement. Plaintiff is a patient of defendant OB/GYN. She alleges that the defendant was negligent in failing to diagnose her cervical cancer. The parties settle the case for defendant's policy limits of $1,000,000.
- 2013, Illinois:$950,000 Settlement. Plaintiff claims that her doctors fail to timely order pap smears and they fail to diagnose her cervical cancer. The cancer is not diagnosed until it is at stage IV. The parties settled before trial for $950,000.
- 2012, Massachusetts:$775,000 Verdict. A woman goes to her primary care physician and is found to have a bleeding cervical mass. She goes to an OB/GYN, who finds a cervical polyp and does a biopsy. The following day, the biopsy is diagnosed as being benign and in conjunction with an infection. The woman is given antibiotics. After several months, she is scheduled for excision of the mass. She seeks a second opinion from a different OB/GYN, who diagnoses her with adenocarcinoma of the cervix. After a radical hysterectomy, the woman has to undergo chemotherapy. Three years later, the woman goes to her doctor with groin and back pain, and cancerous lesions are found in her spine, spleen, and liver. She died shortly after chemo is unsuccessful. Defendants claim the first biopsy did represent a concurrent benign condition, but a jury awarded the woman $775,000.
- 2012, Massachusetts:$400,000 Settlement. A 55-year-old woman has been having pap smears done for ten years. One of the pap smears reveals a lesion with carcinoma, but defendants fail to recommend a hysterectomy. For the next for years, they fail to properly monitor the woman's condition. She brings a claim against the doctors, alleging they were negligent in failing to recommend a hysterectomy given her history of abnormal pap smears. She claims this could have increased her chances of surviving cervical cancer. Just before the woman dies, the parties settle for $400,000.
- 2011, Pennsylvania:$125,000 Settlement. A 31-year-old woman has a pap smear done. She has a history of HPV and precancerous cell formation. She is told the results are negative. Three years later, another pap smear is done, and the results show reactive cellular changes/blood with endometrial cells. A few months later, due to abnormal bleeding, she goes to her physician who does a biopsy. This reveals invasive, moderately differentiated squamous cell carcinoma. She has to have an abdominal hysterectomy done. The plaintiff files this claim, alleging that the original pap smear revealed the abnormal slides. The defense argued that the woman's cervical cancer was slowly growing and that the delayed diagnosis was the result of the plaintiff's own negligence. The parties settled for $125,000.
- 2010, Florida:$650,000 Verdict. A 42-year-old woman goes to her gynecologist who refers her to a pathologist. The pathologist finds cancerous results in a specimen and he recommends a hysterectomy. She seeks a second opinion, but the second gynecologist confirms the cervical cancer diagnosis. The woman's uterus is removed, but a post-surgery biopsy is done and no cancer is found. The woman brings the claim alleging that the doctors failed to properly diagnose her and that they should have ordered more testing before doing the surgery, as she is now unable to have a third child. A jury awards her and her husband $650,000.
- 2009, Tennessee:$5,513,241 Verdict. A 56-year-old woman has two pap smears done a year apart from each other. She is not informed that she has cervical cancer. A year later, she has medical procedures and cervical cancer is found. Doctors review the pap smears that she had done in the prior years and find lesions consistent with cervical cancer. As a result of the diagnosis, she undergoes chemotherapy and radiation. The woman alleges that if her cancer had been caught earlier, she would not have needed these treatments. The defendants eventually admitted liability and negligence as to one of the pap smears. A jury awarded the woman a total of $5,513,241.
- 2009, Massachusetts: $1,300,000 Verdict. A 27-year-old woman has a routine pap smear done. For the next three years, additional pap smears are done, and each are interpreted by defendants as being normal. However, the woman goes back to defendants with bleeding. The defendants attribute this to be an effect of her birth control pill and they attempt a different pill. The bleeding does not stop, and a few months later, the woman returns to defendants, every month, with bleeding, tenderness, and abdominal cramping. Another pap smear is done and it is interpreted as negative, so the defendants just adjust the woman's medication again. A few months later, the woman is diagnosed with cervical cancer that has spread to her rectum, pelvis, and colon. Radiation and chemotherapy treatments are attempted, but she dies due to metastatic cervical cancer less than a year after diagnosis.
- Misdiagnosis Claims: an overview
- Breast Cancer Misdiagnosis (discussion of breast cancer lawsuits)
- Medical Errors by Radiologists
- Maryland Cancer Misdiagnosis Verdicts
- Morcellator Hysterectomy Induced Cancer