Vaginal, not cervical, cancer found after hysterectomy
<court>Orange County (Calif) Superior Court</court>
A 47-year-old woman presented to an Ob/Gyn with a Pap smear indicating cervical intraepithelial neoplasia (CIN) 2. The doctor performed a colposcopy of the cervix and an endocervical curettage, but did not find any abnormalities. The physician then performed a loop electrosurgical excision procedure (LEEP), which was also normal.
He later performed liquid-based cytology (Thin-Prep; Cytyc Corp; Boxborough, Mass), which showed the abnormality from the prior Pap had worsened to CIN 3. Another LEEP was performed, but neither abnormal cells nor dysplasia were revealed.
Believing the abnormalities must be higher in the endocervical canal, the doctor recommended a hysterectomy and oophorectomy. Postoperatively, it was determined that there was no evidence of cancer. Six months later, however, the woman was diagnosed with vaginal cancer.
In suing, the patient contended that the Ob/Gyn was negligent for focusing his cancer search only on her cervix, and not performing a colposcopy of her vagina. She argued that had he checked the vagina for abnormalities, the cancer would have been found and treated in its infancy and her life expectancy extended. She further maintained that the hysterectomy was unnecessary.
The doctor argued that the abnormal Pap offered no indication that colposcopic examination of the vagina was needed. He maintained that the hysterectomy and oophorectomy were reasonable under the circumstances. He added that even if the vaginal cancer had been diagnosed earlier, the treatment required and the patient’s life expectancy would have been the same.
- The jury returned a defense verdict.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.