Skin Cancer Delay $48M
The High Cost: Understanding the $48M Skin Cancer Delay Verdict
A recent $48 million verdict serves as a sobering reminder of the devastating consequences when medical providers deviate from established standards of care. The case involved a patient and his wife. They sued a dermatologist and the practice group. The medical malpractice claim was for the negligent misdiagnosis and delay to treat recurrent skin cancer.
The jury’s decision highlights a critical failure in the continuum of care—one that transformed a treatable condition into a life-altering catastrophe.
What is Peri-Neural Invasion (PNI)?
To understand why this case resulted in such a substantial award, one must first understand the clinical significance of the pathology findings. The doctor had previously removed a skin cancer near the patient’s right ear. The pathology report identified peri-neural invasion (PNI).
Peri-neural invasion occurs when cancer cells wrap around or invade the space surrounding a nerve. It is not merely a localized growth; it is a specialized method of cancer spread. Think of nerves as “highways” for malignant cells. Once a tumor gains access to the nerve sheath, it can travel far beyond the visible margins of the original lesion, moving deep into the head, neck, or even toward the brain.
Why is PNI Important?
PNI is a “high-risk feature” because it is strongly associates with aggressive recurrence. When a pathologist notes PNI, it signals that the cancer is no longer a simple skin-deep issue. It indicates a high probability that microscopic “seeds” of the cancer remain along the nerve path, even if the primary tumor appears to have been removed.
The Appropriate Response to PNI
The discovery of PNI necessitates an immediate escalation in the treatment plan. Standards of care typically require:
- Clear Margins: Ensuring the surgical site is completely free of malignant cells.
- Multidisciplinary Consultation: Consulting with doctors that are specialists outside of dermatology.
- Adjuvant Therapy: Because of the high risk of recurrence, doctors often should refer patients with PNI for radiation therapy to “mop up” any microscopic cells traveling along the nerves.
The Compounding Risk of Skin Cancer Delay: Leukemia and Immunocompromise
The doctor’s failure to act on the PNI further exacerbated the patient’s underlying health status. The patient had a history of cancer and was immunocompromised due to chronic leukemia.
In medical malpractice litigation, the patient’s baseline health is a critical factor in determining the “standard of care.” An immunocompromised system is less capable of fighting off microscopic cancer cells or controlling a recurrence. For a patient like this one, the “wait and see” approach is inherently more dangerous. The lack of a robust immune response means that any delay in diagnosis allows the cancer to progress at an accelerated rate.
The Critical Omission: Referral to a Radiation Oncologist
Despite the PNI and the patient’s immunocompromised state, no referral to a radiation oncologist was made. This omission is a central pillar of the negligence claim.
A radiation oncologist specializes in using high-energy beams to destroy cancer cells. In cases of recurrent or high-risk skin cancer, radiation is often used as a “secondary shield.” While a surgeon removes what they can see, the radiation oncologist treats the surrounding tissue to ensure the “highway” (the nerves) is cleared of remaining disease. By failing to make this referral, the defendants deprived the patient of a vital line of defense.
The Domino Effect of Misdiagnosis
The tragedy deepened months later when a painful lesion appeared in the same area where the doctor had removed the initial cancer. This is a classic “red flag” for recurrence. However, the doctor misdiagnosed the lesion as benign, removed it, and—critically—discarded it without a biopsy.
Discarding tissue without a biopsy when there is a history of high-risk malignancy is a significant breach of protocol. It effectively “blinded” the medical team, allowing the cancer to advance unchecked until it required radical intervention.
The Human Toll: Surgery and Permanent Injury from Skin Cancer Delay
The delayed diagnosis allowed the cancer to invade deep structures of the head and neck. To save the patient’s life, surgeons had to perform extensive, radical surgery. The results were devastating:
- Facial Paralysis: Because the cancer follows the nerves (PNI), surgeons often have to sacrifice the facial nerve to ensure they have removed all malignant tissue. This results in the “dropping” of one side of the face, making it impossible to smile, close an eye, or speak clearly.
- Loss of Hearing: If the cancer invades the ear canal or the auditory nerves, the surgical removal of the tumor often necessitates the removal of the hearing apparatus.
- Disfigurement: Radical head and neck surgery involves the removal of skin, muscle, and sometimes bone, leading to significant changes in physical appearance.
- Chronic Pain: Nerve damage from both the cancer and the surgery can lead to permanent, neuropathic pain that is notoriously difficult to treat.
Breaking Down the $48 Million Damages for Skin Cancer Delay
The jury’s award split into two distinct categories reflecting the different types of harm suffered by the family:
$32 Million for Pain and Suffering
The jury awarded this portion for the physical and emotional agony the patient endured over more than eight years. This covers the physical pain of the cancer, the trauma of the surgeries, the loss of bodily function, and the mental anguish of living with disfigurement and a terminal outlook.
$16 Million for Loss of Consortium
The jury awarded this amount to the patient’s widow. Loss of consortium is a legal claim for the spouse of an injured or deceased person. It compensates for the loss of the “benefits” of a married relationship, including:
- Affection and companionship.
- Comfort and solace.
- Sexual relations.
- The ability of the spouse to provide the same level of emotional and household support they did prior to the injury.
In this case, the jury recognized that the negligence didn’t just hurt the patient; it effectively ended the marriage as the couple had known it, long before his actual passing.
A Final Lesson for Providers and Patients on Skin Cancer Delay
The $48 million verdict underscores the massive exposure healthcare providers face when they ignore high-risk pathology markers and fail to follow established standards of care for vulnerable patients.
For patients, this serves as a reminder to always ask: “Was a biopsy performed, and what were the high-risk features?” For the legal and medical communities, it is a landmark example of how a single ignored pathology note can lead to a lifetime of suffering.
You can read Blog posts on other Verdicts.
Have you or a loved one suffered due to a delayed cancer diagnosis? Contact the Kopec Law Firm now.
Mark Kopec is a top-rated Baltimore medical malpractice lawyer. Contact us at 800-604-0704 to speak directly with Attorney Kopec in a free consultation. The Kopec Law Firm is in Baltimore and helps clients throughout Maryland and Washington, D.C. Thank you for reading the Baltimore Medical Malpractice Lawyer Blog.