Case resolution in death of 56-year old woman following missed diagnosis

Written by Mark Atlee

Atlee Hall recently successfully resolved a matter concerning the failure to properly biopsy a uterine mass resulting in the spread of cancer that led to metastatic disease and the eventual death of a 56–year-old woman one year later. 

The patient initially presented to an OB/GYN with complaints of post-menopausal bleeding. Following an ultrasound, a uterine mass was identified. Prior to surgical excision, the treating OB/GYN did not perform a biopsy to determine if the mass was cancerous, instead proceeding under the assumption that it was a benign uterine mass. The doctor utilized a MyoSure device for removal of the mass. A MyoSure is a long, thin metal tube that is passed through the cervix with a camera and is usually used to remove uterine tissue, especially fibroids and polyps. It has a rotating blade on the end of the wand with a suction opening to extract the tissue. The device also introduces large amounts of fluid to keep the uterus inflated and clear bleeding, which can result in fluid overload. This is important in the context of the removal of a uterine cancer, where the fluid can act as a spreading mechanism through the vascular and lymphatic systems. 

In this case, the defendant OB/GYN failed to do a pre-operative biopsy and undertook a MyoSure procedure without first confirming the presence of cancer. The procedure had to be aborted due to massive fluid overload with a fluid deficit, meaning fluid being retained by the patient, of 2400 mL (or more than 2.5 quarts). It was subsequently determined from some of the uterine tissue obtained during the MyoSure procedure that the patient had uterine cancer, and a total hysterectomy with lymph node removal were performed. Following the hysterectomy and lymphadenectomy, imaging confirmed that there was no indication of metastatic disease throughout the patient’s body. 

Several months later, the patient began experiencing abdominal pain, ultimately presenting to her family physician approximately a year after her MyoSure surgery. Her family physician ordered a CT of the abdomen and chest. The imaging demonstrated multiple masses in her chest/lungs. A biopsy of a mass in the right lobe of the patient’s lung confirmed the presence of metastatic endometrial adenocarcinoma. The patient, our client’s wife, succumbed to the disease a few months later, approximately 15 months after her MyoSure procedure.

The Plaintiff, through multiple experts, was able to establish that the Defendant was negligent in undertaking the MyoSure procedure without first performing a biopsy to rule-in or rule-out the presence of cancer. The Defendant, then by introducing this high-pressure water while using a rotating blade to eviscerate the uterine mass, acted to spread the endometrial cancer through the patient’s vascular and lymphatic system. While there was no initial indication of metastatic disease, Plaintiff’s expert opined to a reasonable degree of medical certainty that the use of this device spread the disease throughout the body, eventually resulting in metastatic endometrial cancer that caused the patient’s death.  This theory was persuasive, and the matter was ultimately resolved to our client’s satisfaction after extensive litigation. 

The Atlee Hall team has extensive experience in root cause analysis of wrongful death in medical malpractice claims. If you or a loved one believes you have experienced medical negligence, contact our office through our website or call: 717-393-9596.