Facts

Doe plaintiff, a 47-year-old auto mechanic, developed a lesion on his right forehead in 2001. He treated with a non-party dermatologist, who performed a biopsy. The non-party dermatologist read the slides as showing diffuse dermatitis, with consideration that the lesion represents lupus erythematosus or morphea. He was treated with topical steroids.

The lesion abated, but did not go away, and so plaintiff went back to the same dermatologist in August 2003. The lesion was again biopsied. A different (non-party) dermatopathologist read the specimen as showing superficial and deep focally granulomatous lymphoid infiltrate.

At that time, plaintiff transferred his care to defendant internist. Plaintiff testified that he brought with him, on the first visit of Aug. 22, 2003, his records and biopsy report from the prior dermatologist.

From August 2003 to August 2008, defendant continued to treat the lesion with steroids. It would wax and wane but would not go away. In 2008, the lesion became more pronounced, thus prompting a referral to a dermatologist.

A biopsy was undertaken in August 2008, which revealed a cutaneous B-cell lymphoma, stage 4 disease. Plaintiff transferred his care to UCLA, where he underwent both adjuvant and intra-thecal chemotherapy over the course of six months. There is no evidence of recurrent disease to date.

PLAINTIFF'S CONTENTIONS:
Plaintiff contended that the accepted standards of care required that by 2005, at the latest, defendant was obligated to refer plaintiff to a dermatologist for a further biopsy. That would have lead to a diagnosis of stage 1 or stage 2 disease and the treatment for which would have been local. By virtue of the delay, the lymphoma invaded plaintiff's skull, thereby requiring aggressive chemotherapy. Although his likelihood of cure remains well above 50 percent, the progression of his disease to stage 4 conferred upon him a worse prognosis.

DEFENDANT'S CONTENTIONS:
Defendant contended that it was reasonable to treat plaintiff, as the prior dermatologist had, with steroids. Once the lesion worsened, a referral to a dermatologist was made.

Settlement Discussions

Plaintiffs demanded $750,000. Defendant offered $200,000.

Result

The case settled before Harrison Sommer, Esq., at Judicate West for $450,000, including plaintiff's wife's loss of consortium claim, and including any potential wrongful death action.