A urologist is a doctor who specializes in treating patients with urinary tract disorders. Most medical malpractice cases against urologist are from failure to accurately diagnose the patient's condition or surgical mistakes. Because urological disorders are often markers for far more serious conditions
- such as cancer of the testicles, kidneys, or prostate - it is often critical that a urologist identifies problems that need to be addressed to limit the risk of serious injury or death.Three Most Common Types of Urology Malpractice Claims
There are three most common types of urology malpractice claims:
- Errors in the operating room
- Failure to monitor
In misdiagnosis cases against urologists, Maryland law applies the same rule it does in any other medical malpractice case. The question is whether the physicians exercised the skill, care, and diligence ordinarily possessed by the average doctor under the circumstances. Most of these misdiagnosis cases involve a missed cancer diagnosis. The most common, in order, are prostate, renal, and bladder cancer misdiagnosis.
Most lawsuits against urologist arise from technical errors in the operating room. No question, urologists perform a lot of surgical procedures: Urologists are called upon by patients to perform procedures such as
- endoscopic surgery (for such things as kidney stones, tumors, strictures, and kidney blockages)
- orchiectomy (removal of one or both of the testicles)
- urethroplasty(reconstruct or fix ureter)
- ureteroscopies (examination of upper urinary tract)
- cystoscopies (a test that doctors use to look at the interior lining of bladder and urethra)
- transurethral prostate resections of the prostate/prostatectomies (for enlarged prostate)
- nephrectomies (remove all or part of the kidney)
- penile implants
- bladder suspension
Of these, some of the most common surgical mishaps involve endoscopy (often ureteral avulsion or perforation), orchiectomy, and penile implants.
Failure to Monitor
The two big issues with failure to monitor patients after urological surgery involve infection and improper medication. Urosepsis, an infection that starts in the urinary tract but can spread to the bloodstream, if not controlled, commonly leads to malpractice (and, parenthetically, nursing home) lawsuits. Medication errors run the gambit of mistakes from lethal drug combinations to transcription errors, to overdoses and everything in between.Sample Settlements and Verdicts
Below are some sample verdicts in Maryland and around the country in urology cases. These verdicts are interesting and illustrative for attorneys trying to figure out how juries value these cases when they believe the doctor made a mistake. But the knowledge you can get from these results is general.
Victims and families bringing a wrongful death claim have to take the value of these verdicts with a handful of salt. You cannot infer the value of your case merely by reading another case that sounds like yours. There are so many variables that go into the value of a particular case. So it is impossible to assume the result in one case is predictive of the result in another.
- September 2013, New York: $3,609,000 Verdict: A nodule had been discovered on the prostate of a 50-year-old maintenance worker. His biopsy did not suggest cancer. His urologist determined the man was suffering from prostatitis – inflammation of the prostate. The man was prescribed antibiotics and advised to return in three months for additional blood work. During the time of examination, an internist had conducted a blood test that revealed a high concentration of prostate-specific antigen, which is an indicator of cancer; this information was not given to the urologist or the patient. Just a classic failure to communicate. The man returned for additional blood work four months later. The blood work showed a dramatic increase in his blood’s concentration of prostate-specific antigen. A second biopsy was conducted of his prostate and revealed advanced cancer. Unfortunately, the cancer had progressed, and he passed away within the year. His wife brought a wrongful death lawsuit alleging that Defendants failed to timely diagnose her husband’s cancer. Defendants denied negligence, somewhat despicably arguing that the decedent did not pursue follow-up testing in a timely matter, causing the delay in diagnosis. Defendants also contended that the decedent suffered from an aggressive form of cancer. The classic, "Even if we screwed up it would not have mattered" defense argument. A Queens' jury saw it for what it was and awarded the Plaintiff $3,609,000.
- June 2013, New York: $1,475,000 Verdict: A 59-year-old retiree underwent a circumcision to relieve an inflammation of the penis’ glans at New York Westchester Square Medical Center in the Bronx. After surgery, he soon noticed a 90-degree curvature of any erection of his penis. He sued the urologist who conducted the surgery for medical malpractice. Plaintiff alleged that Defendant failed to properly perform the circumcision. An expert urologist for Plaintiff’s counsel opined that the Defendant did not properly suture the penis and unknowingly applied a 90-degree rotation of the penis’ skin and dorsal vein. Defendant contended that the circumcision was correctly performed and that the curvature was a result of a previously asymptomatic condition. A Bronx jury awarded the man $1,475,000.
- October 2013, Illinois: $1,808,075 Verdict: A 73-year-old retiree had been referred by his primary care doctor to a urologist due to a rising Prostate-Specific Antigen (PSA). The urologist chose not to repeat the PSA test to confirm the results and suggested a transrectal ultrasound guided biopsy (TRUS biopsy). The procedure involves a spring-loaded needle gun shooting the needle 12 times through the colon into the prostate gland to obtain tissue samples. Besides sounding awful, the procedure itself holds a high risk of infection caused by the presence of E.coli infection in the bowel. Although the man had multiple pre-existing conditions, putting him at greater risk of infection, the procedure was performed. Two days after the biopsy, the man developed an E.coli infection in his urinary tract. The infection soon progressed from his urinary tract to his blood, which ultimately settled in his spine as a bone infection. He passed away two months later. The man’s estate sued the urologist for medical malpractice. Plaintiff's suit claimed the Defendants failed to provide informed consent before conducting the risky procedure. They also argued the obvious: the man was a poor candidate for the biopsy because he had a multitude of conditions that would make it difficult for him to fight post-operative infections. A Cook County jury awarded the Plaintiff $1,808,075.
- May 2008, Maryland: $700,000 Settlement: A 62-year-old mother of four visited a local area hospital’s emergency room complaining of right flank pain. A CT scan was conducted and results showed what appeared to be a kidney stone. The attending urologist ordered shock wave lithotripsy which proved ineffective in removing the mass. Nine months later a series of X-rays and a CT scan was performed, which had no suspicious findings. She returned to the hospital the following month with increased flank pain and anemia. The attending physician ordered a CT scan of her abdomen which revealed a 14x16.4x20 centimeter mass. They immediately began treatment for renal cancer, but unfortunately, she passed away within the month. Her family and estate brought a wrongful death/survival action against the urologist for failing to perform more extensive scans and tests to properly identify the abdominal mass and against the radiologists for failing to properly interpret the scan’s readings. Plaintiff asserted that had the Defendants done so, the cancer would not have been left to grow and metastasize. Defendants denied liability and claimed that their actions fell well within the standard of care. The parties agreed to settle before trial for $700,000. You can learn more about malpractice claims against radiologists here.
- February 2000, Maryland: $2,000,000 Verdict: A man visited his primary care physician after a recent concern with unexplained weight loss and anemia. The doctor referred the man to a radiologist for imaging studies to determine the root of the iron deficiencies. He was soon diagnosed with refractory anemia and began iron supplement treatment. Unfortunately, the treatment was unsuccessful, and the man was referred to a hematologist. The hematologist diagnosed the man with bone marrow disease. Three years after his diagnosis, the man was hospitalized with mental health concerns. The tests revealed renal cell carcinoma that had metastasized to his lungs. He died a year later. The man’s family sued his primary care physician and the radiology group for medical malpractice, claiming Defendants failed to perform a CT scan and properly diagnose and treat his cancer that led to the man’s death. Defendants claimed that all treatment was appropriate and well within the standard of care. A Baltimore City jury awarded the Plaintiff $2,000,000.