The plaintiff had a history of gastroesophageal reflux, and lab tests revealed an elevated gastrin level, for which she underwent an upper endoscopic ultrasound. Biopsies revealed Barrett’s Esophagus, a disorder in which the lining of the esophagus is damaged by stomach acid, as well as the potential for a neuroendocrine tumor in the pancreas.
Doctors removed the pancreatic tumor and adjacent lymph nodes, which were found to contain gastrinoma. The prognosis for such a lesion is good, but requires periodic surveillance of the pancreas and esophagus by endoscopic ultrasound, otherwise known as EUS. Plaintiff alleged that it was the responsibility of the attending gastroenterologist who performed the periodic EUS to determine the timing of the procedures and to communicate the results and significance of the biopsies.
Fourteen months later, the plaintiff underwent a follow-up EUS with biopsy, which revealed Barrett’s Esophagus with low-grade dysplasia. However, the plaintiff claimed that she was told her biopsies were normal. Two years after that, she again returned for an EUS, but claimed in her lawsuit that the appropriate medical standard of care required that she have the repeat biopsy within six months. Again, the plaintiff claimed that she was told her EUS results on that occasion were normal, but that the report showed high-grade dysplasia.
Some months later, plaintiff returned for more biopsies, which revealed the progression of the gastrinoma into Stage III esophageal carcinoma, with a very poor prognosis for survival. The plaintiff died 28 months later during the pendency of litigation, after clinical courses of aggressive chemotherapy.
With plaintiff’s experts ready to testify that early removal of the distal portion of the esophagus following the finding of high-grade dysplasia would have vastly increased her chances of survival, the defendant doctors settled the case for $2.75 million before trial.
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