Doctor who failed to consider possible cancer diagnosis ordered to pay $125,000 in damages and cost

A Coquitlam, B.C., family doctor has been ordered to pay $124,000 in damages and $726.01 healthcare recovery costs after a British Columbia court ruled he had been negligent when he failed to investigate a possible cancer diagnosis–an oversight that contributed to the patient’s prolonged pain. However, based on expert evidence presented in court, Dr. Herbert Y.C. Chang–whom B.C. Justice Janet Winteringham described as an “honest and forthright witness”–is not liable for the patient’s “bleak” prognosis, according to a CTV News report. The patient’s cancer, which had grown undetected, was likely inoperable even five months before it was discovered, the judge wrote in her overview of the case. Read: The importance of early detection in ovarian cancer: A patient's journey through diagnosis and treatment In 2017, Dr. Chang told a female patient who saw him eight times over nine months that her persistent back pain was caused by facet joint irritation. He suggested she do some stretching and core strengthening exercise, and take ibuprofen as needed, according to a CTV News report. The patient had completed cancer treatment a year before she started to experience back pain. During one of her visits with Dr. Chang, she asked him if her pain might be related to her cancer but he affirmed his diagnosis of facet joint irritation–a conclusion Justice Winteringham deemed reasonable given that the patient noticed the pain while doing exercises. But a court re-examination of a bone CT scan taken in October 2017 during the patient’s visit to an emergency department–and which Dr. Chang had noted did not show “any significant disc bulging or nerve root irritation”–found a mass measuring about five centimetres. By February 2018, that five-centimetre mass had grown to 13 centimetres–too large to operate on. "The plaintiff claims earlier diagnosis would have improved her prognosis/life expectancy, which now is approximately three to five years," Justice Winteringham wrote. The plaintiff also argued that even if the mass couldn't have been surgically removed, her doctor's negligence allowed it to grow, causing "unnecessary, significant and ongoing pain,” wrote the judge. According to CTV News, Dr. Chang’s notes from September 2017 suggest he was considering a bone scan if the pain didn’t get better, but he also noted the patient seemed to be improving gradually. Shortly after he made these notes, Dr. Chang received the results of the patient’s ultrasound from the B.C. Cancer Agency and called the patient to let her know no cancer was detected. When questioned in court, however, he agreed cancer could not be ruled out fully by ultrasound. A month after Dr. Chang received the ultrasound, the patient’s pain became so severe she had to go to the hospital. After an eight-hour wait in the emergency department, the patient saw a doctor, who ordered the bone CT scan later assessed by Dr. Chang and prescribed a muscle relaxant and pain medication. Read: Learn to live with your mistakes Because the patient’s cancer had grown to the point of being inoperable, she has had to undergo “gruelling treatment” that included 30 “agressive” radiation treatments and chemotherapy, Justice Winteringham said in her ruling. However, after suffering from the side effect of chemo–nausea, bone pain, blisters, hair loss and anemia, the patient was told by her doctors she would not benefit from this therapy. She has since gone across the border to Washington state to get immunotherapy, an expensive treatment her family has paid for. Dr. Chang’s lawyer argued that argued that his client had met the standard of care expected "of a reasonable family physician," and that this is not something that can be "measured against the wisdom of hindsight." Even if Dr. Chang did breach the standard of care, that wasn't the cause of the patient’s injury, the lawyer said. Read: Physician tips: How to not get yourself sued

Doctor who failed to consider possible cancer diagnosis ordered to pay $125,000 in damages and cost

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