This month we look at a case where a jury was asked to hold a patient partially responsible for his own injury based on the fact that he was a retired chiropractor, and thus had some medical background.

The patient, Mr F was in his early 60’s when he went to his primary care physician to have a lump on his neck looked at. The physician ordered an MRI and referred Mr F to a specialist, Dr M.  The MRI of the patient’s face and neck took place on November 28th. The patient faxed the MRI report to Dr M the following morning before seeing him. Dr M confirmed with the patient that he had received the MRI report, but he did not discuss the report with the patient, nor did he ever review it. [The report was highly suggestive that the neck mass was cancer.]

Dr M, not having read the report, believed the lump was a cyst, and performed a fine needle aspiration during the initial November 29th appointment. Despite the aspiration, the lump continued to grow, and on February 8th, Dr M surgically removed the mass. During surgery, however, the lump ruptured several times spilling fluid from the mass into and around the surgical field.

The pathology report revealed that the ruptured mass was cancerous. After seeing the pathology report, Dr M scoped the patient’s throat and saw a tumor at the base of his tongue, which had been visible in the original MRI. It too was cancerous.

The patient sought treatment at a Cancer Center, where he was given radiation and chemotherapy. Due to the spill of cancer cells into the side of Mr F’s neck during the earlier surgery, the dose of radiation and the size of the radiation field had to be increased. As a direct result, a larger portion of Mr F’s mandible received high-dose radiation and led to a complication known as osteoradionecrosis (ORN). The patient was diagnosed with Stage 4 ORN which caused his jaw to fracture and required the surgical removal of the left half of Mr F’s mandible. The removed mandible was replaced by an implanted titanium plate.