Tongue Cancer Delayed Diagnosis Lawsuit

Johnson v. Montgomery Otolaryngology Consultants

Tongue CancerThis wrongful death claim was filed against an ENT Montgomery County after a negligently delayed tongue cancer diagnosis. It was filed in Health Claims Arbitration on February 6, 2018, and it is the 64th medical malpractice case filed in Maryland this year.

Summary of Plaintiff's Allegations

A man went to his ear, nose, and throat (ENT) doctor with complaints of dizziness, pressure in his left ear, and discomfort in the back of his tongue. The doctor examined the man and performed a superficial biopsy of the tongue lesion in the man's mouth. The man was later informed that the biopsy results were benign and he didn't need to undergo any further evaluations or testing.

Three months later, the man returned to his ENT doctor with continuing complaints of intermittent left ear pain and discomfort in the back left tongue area. At that time, the doctor recommended that the man undergo further evaluations and testing. The man then underwent an MRI which showed a mass in his left posterior tongue area - the same site that the doctor had supposedly biopsied months earlier. The mass turned out to be a squamous cell carcinoma (cancer).

The man underwent multiple procedures in an attempt to cure his cancer, including the removal of one-third of his tongue, lymph node dissecting in his neck, thirty-nine radiation treatments, and salvage chemotherapy. Unfortunately, none of the treatments were successful and the man passed away eleven months after the diagnosis.

Additional Comments
  • While the ENT doctor certainly provided substandard medical care, oftentimes the key in a cancer misdiagnosis lawsuit is proving that the cancer was clearly detectable at the time of the missed diagnosis. Was the squamous cell carcinoma noticeable in the biopsy taken during the man's first appointment with the ENT doctor? Did the doctor misinterpret the biopsy results or did he perform an inadequate biopsy? These are the types of questions that a qualified medical expert witness, such as another ENT doctor, needs to answer.

  • Tongue cancer can spread two ways. There are little lymph channels that pick up excess fluid that then drain into lymph nodes. These are the same kernels that come up in your neck when you get an infection, and then eventually these empty back into the bloodstream. The 5-year survival rate for cancer in patients where the lymph nodes are involved is 64%. Another method that the cancer can spread is via the arteries that bring blood to the tongue. These cancer cells can then get into the body, break loose, and enter the general circulation sending them all over the body. If cancer has spread to a distant part of the body, the 5-year survival rate falls to 39%.

  • Sometimes, tongue cancer is insidious, particularly cancer at the base of the tongue. In these cases, patients do not have any symptoms until the disease has reached an advanced stage. As the National Cancer Institute says that, "Tongue base cancers are among the most challenging tumors to manage. These neoplasms remain asymptomatic and hidden for quite some time before they are diagnosed, so most patients are seen at an advanced stage."

  • A lesion on the left lateral border of the tongue was the most likely area for tongue cancer so doctors should be particularly alert for that presentation.

  • Squamous cell carcinoma, is the most common form of oral cancer. It accounts for more than 90% of all oral cancers. Squamous cell carcinoma develops from the squamous epithelium that lines the soft tissues of the oral cavity. The most common oral location for this cancer is the tongue. Chronic exposure to tobacco smoke is the major risk factor for oral squamous cell carcinoma.

  • A common defense in any cancer misdiagnosis is causation. The doctor's lawyer argues that even if the cancer had been caught in time, it would not have made a difference. This will certainly be the argument this ENT will make.

Jurisdiction Defendants
  • An otolaryngologist
  • Montgomery Otolaryngology Consultants, P.A.
Negligence
  • Failing to conduct a proper biopsy.
  • Failing to follow up on the biopsy report.
  • Failing to refer the man for further testing.
  • Failing to perform a diagnostic biopsy.
Specific Counts Pled
  • The man suffered a delayed cancer diagnosis and died as a result of the defendant's negligence.
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