LUNG CANCER MEDICAL NEGLIGENCE INADEQUATE TEST FOLLOW UP

John Whelan Solicitor with specialist expertise in Lung Cancer Medical Negligence gives an example of a inadequate test follow up, where the failure to properly identify the condition led to delays in treatment and worsened the patient's outcome:

Case Example: Inadequate Follow-up on Abnormal Chest X-Ray

Patient Background:

A Patient with a history of hypertension and smoking history visits the GP for an annual check-up.  The Patient is asymptomatic, without a cough, shortness of breath, or weight loss, but hasn’t seen a doctor in several years. The Patient’s GP orders routine blood work and a chest Xray due to the smoking history, as part of the preventive care assessment.

Imaging Result:

The chest X-ray reveals a 2.5 cm nodule in the right upper lobe of the lung, which is classified as indeterminate but suspicious for possible malignancy. The radiology report recommends further evaluation with a CT scan and possibly a biopsy to determine the nature of the nodule.

Inadequate Follow-up:

a) The GP receives the report but is busy with other cases and forgets to discuss the findings with the Patient.

b) The GP does not schedule a follow up visit or order the recommended CT scan for further evaluation of the lung nodule.

c)The Patient, unaware of the abnormal result, assumes everything is fine since he doesn’t receive any communication from the doctor and continues his regular routine.

Progression:

Six months later, the Patient returns to the GP’s office with new symptoms, including a persistent cough, fatigue, and unexplained weight loss of 6kg.   A CT scan is finally ordered, which shows the nodule has grown to 4.5 cm with evidence of lymph node involvement. A subsequent biopsy confirms stage III non small cell lung cancer, and additional imaging reveals that the cancer has spread to the mediastinum.

Delay:

The failure to promptly follow up on the abnormal chest X-ray led to a significant delay in diagnosis. Six months passed without action, allowing the cancer to grow and progress from a potentially early stage to an advanced stage lung cancer. Had the Patient undergone further imaging and diagnostic tests after the initial Xray, the lung cancer could have been diagnosed and treated at an earlier stage.

Important Points from the Case:

1. Failure to Act on Abnormal Results.  
2. Inadequate Communication.
3. Lack of a Tracking System.

What should have been done:

• Prompt Communication of Abnormal Results.
• Follow Up Systems.
• Patient Engagement.

For more detailed insights into how the Patient Safety Act 2023 impacts you and how Whelan Law can support you, please visit our Lung Cancer Medical Negligence https://www.whelanlaw.ie/news/rising-lung-cancer-medical-negligence-claims-a-reflection-of-modern-medicine/