A court in Iowa has awarded $12.5 million to a plaintiff who underwent invasive surgery to treat prostate cancer after the defendant, a pathologist, mixed up the cancer-free man’s records with those of another patient who actually had prostate cancer.
The problem began in early 2017, when the plaintiff, a retired factory worker in his 60s, visited his urologist, complaining of mild urinary incontinence. The urologist took a blood sample and ordered tests to determine whether the patient had prostate cancer. Based on the blood test results, the urologist recommended that the patient have a tissue sample taken from his prostate gland and have the sample evaluated for cancer.
The error happened when the pathologist examined the slides, each of which had been marked with a barcode. The pathologist scanned each slide as she examined it and entered notes into the patient’s medical chart. Because of a glitch with the barcode scanner, the pathologist’s notes about a tissue sample that was positive for prostate cancer ended up in the plaintiff’s medical records. Therefore, the plaintiff’s urologist received the pathologist’s recommendation to remove the plaintiff’s prostate gland.
The plaintiff underwent surgery in April 2017. The urologist removed the plaintiff’s prostate gland. After the surgery, the plaintiff suffered common undesirable effects of radical prostatectomy and the resulting nerve damage, including urinary incontinence and loss of sexual function. Although these risks of prostate gland removal are unpleasant and well known, many patients choose this treatment because it is better than giving the cancer a chance to spread.
The plaintiff did not, however, have prostate cancer, as he discovered after the surgery. Another pathologist tested a tissue sample from the patient’s prostate gland after it had been removed and found that it was cancer-free. Only then could the other patient, the one whose tissue sample the barcode scanner had mixed up was the patient’s sample, be identified and notified that he had prostate cancer and required treatment.
The plaintiff filed a lawsuit in 2017, shortly after he discovered that the surgery that had deprived him of sexual function and bladder control had been entirely unnecessary. They named as defendant the clinic where the mix-up had taken place and the pathologist who had reviewed the tissue samples and incorrectly recommended prostate gland removal for the plaintiff; the pathologist was a partial owner of the clinic. In the lawsuit, there was little question that the medical error that led to the unnecessary surgery constituted negligence on the part of the pathologist. The biggest point of contention in the trial was about the appropriate amount of compensation to which the plaintiff and his wife were entitled. Originally, the plaintiff requested $15 million, while lawyers for the defendants suggested that $750,000 was an appropriate amount.
The plaintiff’s wife gave emotional testimony during the trial. She described the ways in which her husband’s unnecessary surgery had changed their lives. She said that she and her husband could no longer be sexually intimate in the ways that they had been before the surgery. She also said that, while her husband’s bladder control had improved in the year between the surgery and the trial, he still suffered from incontinence severe enough to require incontinence pads. She said that, because of his incontinence, he often smelled of urine, which was a source of embarrassment for him, especially when his grandchildren made comments about the smell. Meanwhile, attorneys for the plaintiff argued that, while having a healthy body part removed because of a medical error is traumatic, it is especially traumatic when that body part is something like a prostate gland, where removing it costs the patient several important markers of adulthood, such as bladder control and sexual function.
Attorneys for the defendant never denied that the surgery was unnecessary or that the pathologist’s failure to notice the mix-up constituted negligence. Rather, they argued that the plaintiff’s loss of bladder control was not entirely due to the surgery. Before the surgery, the plaintiff had already seen a urologist about urinary incontinence serious enough to persuade the urologist to have the plaintiff evaluated for prostate cancer. The attorneys for the defendant argued that the defendant’s actions had not been the sole cause of the plaintiff’s problems. They said that, if anything, the surgery had only worsened existing problems instead of creating new symptoms.
In the end, the court awarded the plaintiff $12.5 million in damages. The pathologist did not testify at the trial about the details of the mix-up. After the trial, she stated that barcode scanner glitches had happened before at the clinic where she worked. She said that this mix-up had completely changed the way that she would deal with tissue samples; she knew that she could no longer rely on barcodes alone to match tissue samples to the correct patients.
Even in medical malpractice trials like this one, where the medical error is so obvious that no one questions whether there was negligence, medical expert witnesses still play a key role. In this case, they helped determine the extent to which the defendant’s actions caused the plaintiff’s present state.
