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Medical Error

Medical Error

Posted by Mon1 on May 25, 2020 12:15 pm

Has anyone experienced Medical Errors during their journey from diagnosis forward to treatment?  A few things just don't add up and I am supposed to start chemo on Jun 16.  
Specifically - The Surgeon told me he removed 4 Lymph nodes - The Medical Oncologist who is setting my Chemo regimen said 2 out of 3 Lymph nodes had cancer cells present. Also - 2  different Radiologists measured the tumor at just under 2 cm.  The Medical Oncologist said the pathology showed that it was TWICE as big - 4 cm.  Is a size difference like that common?  I realize that I don't want the bad news and wish my results were better; however, I want to make sure that everything is correct.  Any advice?

Re: Medical Error

Posted by Wendy Tea on May 25, 2020 12:24 pm

Mon1‍  Is it possible to receive a copy of the pathology report? I was given mine after my mastectomy and it has taken lots of rereading to understand the nuances.  I think that is the first thing I would do. If you have a family doctor they might be willing to explain the report to you as they will have fresh eyes.  Please let us know if you can.
Healing takes time and opportunity. Wendy Tea

Re: Medical Error

Posted by Buffythevampire on May 25, 2020 1:11 pm

Mon1‍  as Wendy Tea‍  responded, ask for the paperwork. I had a situation that bothered me in the beginning. My first appointment in May 2019 with the medical oncologist didn't go so well. First she told me about my cancer and all the technical stuff about cancer and then she examined me.She found a lump in my right breast (mastectomy/reconstruction in left breast) and questioned on whether the surgeon's had done an exam prior to my surgery and said "they should have removed both". She sent me for an mammogram/ultrasound and a biopsy. I went for my mammogram/ultrasound appointment and the tech's printed off my previous exams to show the tech who was going to need them to review. I then had an appointment with my family Doctor and she told me the results from my mammogram/ultrasound and it was noted that I didn't need a biopsy after all. From a previous MRI that I had done in December 2018 that lump was discovered and was I believe a cyst. The hospital that was where I was to get my chemo treatments I called to find out when my treatments were to start and they said they were waiting on the biopsy results. I had to tell them to look into my file and let the Medical Oncologist to schedule my chemo treatments. My medical oncologist hadn't looked at all of my file before my first appointment and upset me for no reason. Plus I had to get the ball rolling on my chemo treatments also.

You have to be an advocate for yourself. Hopefully you can get the answers you need soon.

Re: Medical Error

Posted by Mon1 on May 25, 2020 1:19 pm

Thank you for your message.  I am felling so overwhelmed.  Its just one bit of bad news after another.  When things don't add up, I always second guess myself because I am aware that |I really wanted a different outcome.  I just requested my chart from the Cancer center and have put in a call to my surgeon and asked him to go over the pathology with me so I can ask him about the discrepencies.  I read that 1 in every 18 Canadians who are admitted to hospital experience one or more Medical errors.  😲

Re: Medical Error

Posted by ashcon on May 25, 2020 3:31 pm

Hi Mon1‍ 
Getting updated or changing information is not that uncommon, as more reports and information comes forth from all the tests you go through. Including the pathology tests.
In your case, the radiologists "saw" a tumour that was just under 2cm. Unfortunately, imaging is not always 100% accurate. 
(This was true for a friend of mine who had it "backfire" in a good way - the "tumour" that the surgeon thought was a metastasis to his liver was just a shadow or something on the imaging.  This little "oopsie" was only discovered though AFTER the surgeon had cut him open!)

I'm not a doctor but there seems to be consensus that the pathology report information trumps screening or diagnostic imaging as far as providing a "true" picture of the details of your cancer. 
The question is this: will your treatment plan be any different based on whether the tumour was 2 cm or 4 cm? Or whether 4 nodes were removed, or 3?

My surgeon said he removed 4 lymph nodes, but pathology revealed that he removed 8 (the nodes were "split", so therefore, doubled). I got frustrated when my surgeon also said my cancer was invasive lobular cancer, but my oncologist said it was invasive ductal.  Turns out, my pathology report said "invasive ductal carcinoma with lobular features" 
Bottom line - my treatment plan would have been the same regardless. And I learned that even doctors make mistakes.  As long as they are minor mistakes, and your ultimate treatment plan aligns with the standard of care for your type, stage, and grade of cancer.

Like the others have said, yes, get copies of all your reports.  And with the report in hand, ask your doctor to walk you through each line or section, asking them to explain to you what it means, especially what it means to your treatment plan. 

May you have knowledge, but also peace with that knowledge!
---- "Nothing ever becomes real till it is experienced." ----

Re: Medical Error

Posted by Essjay on May 25, 2020 5:07 pm

Mon1‍ it doesn’t sound like an error...

The imaging is done to evaluate whether a lump is something of concern, but it cannot diagnose cancer, and it’s not all that good at sizing either, and really the radiologist can only give his best judgement based on what he can see. A little more information is gleaned through a biopsy - is it cancer, what kind etc. But the most valuable information is found during examination of the mass after surgery. This is the pathology report that your oncologist will use to plan treatment.

I had a 2cm mass according to my ultrasound, but when the pathology was done on it, it turned out to be a multifocal mass - a group of cancers together including invasive ductal carcinoma and ductal carcinoma in situ, and it was all surrounded by fatty tissue and blood vessels, and quite a bit bigger than the ultrasound suggested.

As others have said, get a copy of the pathology report, and take it from there.

Welcome to the community - lots of really helpful people on here xx
Triple Negative Breast Cancer survivor since July 2018

Re: Medical Error

Posted by Mon1 on May 27, 2020 10:29 am

You're right - I did get a copy of the Pathology report.  I asked the Surgeon to call me and he kindly explained the size discrepancy.  He did; however, say that the Medical Oncologist definitely misread the report when she told me that there were only 3 Lymph nodes and that 2 out of 3 were affected.  The report clearly says there were 4 lymph nodes and 2 out 4 were affected.  it doesn't actually make a difference in the proposed regimen - but one expects the doctors to give you the correct information.  It helps that I now have the report.
Thank you for your advice

Re: Medical Error

Posted by Laika57 on May 28, 2020 4:07 pm

Different doctors have different specialties. the gastroenterologist who first found my husband's cancer said it wasn't operable, but referred him to a hot shot surgeon. the surgeon is like "oh he doesn't see too many of these, we do this operation all the time, no biggie".
so i've learned that doctors are very, VERY specific in their areas of expertise. the trick is to find out who knows what. also, at the local hospital, they simply will not give you plain answers. to the point where they ask if you've ever been diagnosed with arrhytmias or  congestive heart failure - but won't ever mention it again, just prescribe you meds for both those conditions.
an actual treatment error we have encountered was with my husband's insulin. he was told to fast for an ultrasound. his blood sugar was below 4, yet the nurse still gave him his mealtime insulin. he told me all this over the phone, sounding like he was drunk. i had to call the nurses supervisor and explain he was hypoglycemic and confused and they needed to do something about it pronto - the doctor blamed the nurse, who said she couldn't go against (the other) doctors orders, which were to give him ALL his meds. and patient relations has not gotten back to me on the subject in 3 months now. - all i did was ask what their plan was to prevent such an occurrence in future. didn't even mention law suits or anything. though i was certainly angry enough at the time.

Re: Medical Error

Posted by PastaCat on Jun 24, 2020 11:38 am

As a Nurse with cancer I second Laika57‍ . Doctors are so specialized it's unbelievable sometimes. My GP read my surgical report as "nothing to worry about. follow up in 6 months". The surgeon called me 4 weeks earlier than planned and told me "this is incredibly serious, I'm ordering a bunch of tests". That's a massive discrepancy in reactions! I've had to contact Health Records in Alberta to get copies of all of my paper work, from surgery to histology (where they assess taken out bits to see what's wrong with them). Thankfully I can read these records, with a little textbook diving to help with the more obscure concepts. If you need help reading these things, as they can be incredibly technical, I'd suggest taking them to Drs appointments with you and requesting a breakdown. You can't always trust the internet!!

PUSH HARD for a specialist who you can understand and has good bedside manner. You can always request another doctor, don't worry about their feelings, it's your life. You can ask for second and even third opinions if no one will answer the questions you want answered. It may go against your personality (I know it does mine), but if you think about it as "life or limb" I find that I can get bold.

This is your health and life; you DESERVE answers.