Failure to Detect Cancer

The most prevalent reason for a delay in diagnosis is the failure of the physician to be impressed by physical findings. This accounts for 35% of all breast cancer cases. The second most frequent reason for the delay in diagnosis is a failure to follow-up with the patient in a timely fashion, following a negative mammogram report, a misread mammogram, failing to do a proper biopsy, and a delay or failure to request a second consultation.

What should you do?

Make sure that your physician documents all of your complaints relative to your breast and ask your doctor if there is need for further diagnostic studies. It’s also very important to inform your physician about your family history, and to advise your physician whether or not you have had any prior mammograms. Many cancers are missed because radiologists frequently didn’t know about previous mammograms or failed to compare previous mammograms with the current film. It is extremely important to keep your follow-up appointments. Women who fail to keep follow-up appointments could be compromising their health, especially if they have cancer and it goes untreated. Keep in mind that a tumor can double in size every three months. If your doctor can palpate (feel) a mass that your mammogram cannot detect, your doctor is required to do a biopsy. Pregnant women can also have a high incidence of developing breast cancer. If you are pregnant, diagnostic testing can still be performed. Mammograms can sometimes be of poor quality because of patient movement. If the patient moves during the mammogram, a tumor may not be seen, especially if cancers develop in the chest wall. Make sure you follow the instructions of the technician doing the study to ensure that your chest wall appears in the mammography field.

What should your primary care physician do?

Doctors should not abandon diagnostic test because of unimpressive physical findings. Doctors should perform thorough breast exams on each female patient as part of a physical examination, regardless of age or complaints. If a mass is palpated or suspected, additional studies must be done to rule out malignancy. Be sure that patients understand the need for subsequent studies, and document this fact. Perform regular follow-up examinations on patients who present with complaints related to the breast.

What should your radiologist do?

If a mammogram results in a film of poor technical quality, repeat the study. If the mammogram results are equivocal, recommend a repeat study, additional views, follow-up studies, other imaging modalities, etc., as appropriate. Be sure an adequate physical examination was performed and documented. Compare the results of the present study to all previous studies that were performed. Promptly report your findings to the referring physician; if the patient was self-referred, the results of the study should be directly mailed to her. (If there is any suspicion of an abnormality, the patient should also be advised and told to consult promptly with her primary care physician or an OB/GYN.) If you are performing a screening mammogram on a self-referred patient, be sure to do a thorough breast exam, or advise the patient of the importance of a physical breast exam to complement the mammographic study. In cases in which the patient is self-referred, the radiologist is responsible for ensuring she receives proper follow-up visits.

What should your surgeon do?

When a patient is referred, always perform an adequate examination and document your findings, especially when the referring physician’s findings were unimpressive. When performing a biopsy, be sure the correct lesion is removed, in both open and needle procedures. A specimen x-ray of the biopsy should always be obtained. Promptly report consultation and biopsy results to referring physicians. Many times referring physicians are difficult to reach by telephone. Calls to the referring physician should be documented.

Jersey City Lawyer Wins $16.4 million Jury Award for Asbestos Victims in Brooklyn

Jersey City, NJ – May , 2006

A Brooklyn jury awarded three retired Long Island Railroad (LIRR) workers a total of 16.4 million dollars for lung disease caused by their exposure to asbestos while working for the railroad. Following an eight day jury trial before the Honorable Lawrence Knipel, Albito Velez-Zapata (age 61) of Massepequa Park, New York was awarded 8 million dollars, Lincoln Aguirre (age 61) of Deer Park, New York was awarded 6 million dollars and James Harrington (age 54) of Brookville, New York was awarded 2.4 million dollars. The consolidated claims were filed under the Federal Employee’s Liability Act (FELA), a special law designed to protect interstate railroad workers.

The workers, all machinists, represented by Alan T. Friedman of Jersey City’s Bagolie Friedman Injury Lawyers and Paul Garner, affiliated with Jersey City’s Horn Shechtman, were exposed to deadly asbestos fibers while grinding gaskets on a high revolution wire wheel and while working around contaminated rail cars and locomotives. The jury found that the railroad knew about the dangers of asbestos dust beginning in the 1930s and failed warn their workers of the dangers and failed to protect them from the deadly fibers.

LIRR argued that the dust masks were available to the workers, despite the fact that their own Asbestos Awareness Program advised that dust masks were not adequate protection for workers exposed to asbestos. This Asbestos Awareness Program was not implemented until the 1990’s, long after other industries had reacted to their asbestos problems. Additionally, the Long Island Railroad was fined by the State of New York in the 1990’s for failing to implement a Right to Know program to advise their workers of workplace hazards. A Federal law requiring this type of program had been passed in the 1980’s.

“The LIRR treated these workers as if they were expendable or disposable, just like the machines that it was their job to repair. The railroad considered them human overhead. This jury told the LIRR in a loud, clear voice that this is no way to treat your employees” said attorney Alan Friedman.

The cases, Aguirre, Harrington & Velez Zappata v. Long Island Railroad Company, Docket Nos.: 26113-96; 26112-96; 26114-96 Supreme Court of New York, Kings County, were decided on April 26, 2006. Plaintiff’s experts included Pulmonologist Dr. Victor Marcione of Jersey City, NJ and liability expert, industrial hygienist, Dr. Michael Ellenbecker of Boston, MA

This is the second time that attorney Friedman has gotten a multi-million dollar verdict against LIIRR for asbestosis and lung disease. Alan T. Friedman has been certified as a Civil Trial Attorney by the New Jersey Supreme Court and is a founding partner of Bagolie Friedman Injury Lawyers, of Jersey City & Clifton, NJ and affiliate offices in Hollywood, Florida and Brisbane, Australia.