$150,000 Settlement for Wrongful Death - Doctors Misdiagnose Melanoma as a Benign Wart

In this wrongful death case, the plaintiff contended that each of the defendants deviated from the standard of care in failing to diagnose melanoma, and as a result the melanoma went undetected and spread, resulting in the death of the plaintiff's decedent.

In November 1997, a podiatrist saw the plaintiff's decedent. The podiatrist noted a lesion that was three-fourths of a centimeter on the plaintiff's decedent's right heel. The podiatrist thought the lesion was a verruca (wart). He advised the plaintiff's decedent to put an acid patch on the lesion, which she did.

Seven months later, the plaintiff's decedent saw the podiatrist again with complaints of pain in her right heel. The podiatrist examined the heel and noted that the lesion had grown to two centimeters. He recommended that the plaintiff's decedent see a dermatologist.

The plaintiff's decedent saw defendant #1, a dermatologist, several weeks later, in July 1998. Defendant #1 also thought the lesion looked like a wart, and he planned cryosurgery. The plaintiff's decedent returned to the defendant's office for the cryosurgery in August 1998. Defendant #1 was on vacation, and the plaintiff's decedent saw defendant #2, a dermatologist. Defendant #2 also thought the lesion looked like a wart. He performed cryo-surgery and electrodessication. He sent the tissue fragments to the lab for evaluation.

Defendant #3, a pathologist, interpreted and reported the results of the biopsy as a benign verruca vulgaris (wart).

The plaintiff's decedent saw defendant #1 again in September and early October 1998, complaining of pain in the bottom of her heel. Defendant #1 said that the area was inflamed or infected, and prescribed a round of antibiotics. The plaintiff's decedent consulted a surgeon at the end of October 1998, who, like the defendants, did not consider melanoma as a possible diagnosis.

In early November 1998, defendant #1 performed a second biopsy. That biopsy was sent to the lab and interpreted as melanoma. Six weeks later, surgery was performed to remove the melanoma. Final pathology revealed a malignant melanoma with a satellite lesion that was approximately 1.8 centimeters from the main tumor mass and which was also malignant. The tumor was deeply invasive, approximately 0.8- to 0.9-centimeters thick. The Clark's level was 5.

The plaintiff's decedent underwent treatment, but over the course of the following year lung metastases were discovered, and the plaintiff's decedent ultimately died of metastatic disease.

The plaintiff contended that defendant #1 and defendant #2 were negligent in failing to recognize that the lesion was consistent with melanoma and to excise the lesion in its entirety, rather than to recommend or perform cryosurgery and electrodesication — processes that could result in spread of the disease and make identification of the disease by a pathologist more difficult.

The plaintiff also contended that defendant #3 should have been able to recognize that the tissue fragments were consistent with melanoma even though the tissue had been disturbed. The plaintiff further alleged that the plaintiff's decedent's death could have been prevented if the disease had been detected at or about August 1997, when the tissue fragments were sent to the lab.

Defendants #1 and #2 and their experts were expected to testify at trial that the lesion looked like a wart, and that even the surgeon, who did not see the decedent until October 1998, just prior to the diagnosis having been made and who was not named as a defendant, did not consider melanoma as a possible diagnosis. Defendant #3 was expected to testify that the tissue fragments were consistent with a wart.

Each of the defendants and their experts were expected to testify that the plaintiff's decedent had developed a satellite lesion, which was consistent with spread of the disease, prior to having been treated by any of the defendants.

Based on the presence of the satellite lesion and a delay in diagnosis of four months or less, the defendants and their experts were expected to testify that the lesion had metastasized long before any of the defendants were involved in the plaintiff's decedent's care and treatment, and, accordingly, the defendants' care and treatment could not have altered the course of the disease.

The case settled after discovery.