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Failures to communicate continue to bedevil the medical profession. Patient deaths and injuries due to communication breakdowns are especially tragic, because the preventative measure, was often as simple as picking up a telephone or sending a note. In an era of multi-million dollar technology and advanced bioscience, person-to-person communication remains a cornerstone of good medical care. Communication failures lead annually to thousands of medication errors and other forms of medical malpractice.

The doctors treating a western Massachusetts woman, did not communicate, and their patient died as a result. After a small mass was discovered in the decedent’s stomach during a routine gynecological exam in 1995, she went to a surgeon, who removed it and sent it to the pathology laboratory for analysis. The tumor was found to be malignant, a result that was promptly sent to the woman’s surgeon and to her internist. In an appalling case of “it’s not my department,” neither doctor notified their patient of the potentially lethal malignancy that they knew, but she did not know, was in her body.

For the next four years, the woman made multiple visits to her internist for routine medical reasons. He never mentioned that she had cancer, assuming that the surgeon would have told her. The surgeon decided that it was the internist’s responsibility to notify the patient, so he filed the report away, and said nothing. The woman only learned that she had cancer, in 1999, when another doctor, reviewing her file, told her about it. The cancer was finally treated, but by 1999, the cancer had metastasized, resulting in the woman’s death in 2005, from the tumor that had been determined to be cancerous in 1995. Although the defense contended that even a prompt diagnosis in 1995 would not have changed the outcome, the internist settled with the patient during trial, and the jury awarded a substantial verdict against the surgeon.

Almost as disgraceful as the neglect of the doctors, was the decision of their malpractice insurer to force the case to trial. The insurance industry loves to complain about out of control costs related to medical malpractice. A large cost results when insurance companies force cases to trial on causation defenses, even in the face of appalling medical negligence. The case was reported in last week’s Massachusetts Lawyers Weekly newspaper.

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