Facts

On Jan. 3, 2007, the plaintiff, a 37-year-old husband and father of two young girls presented to an emergency room with complaints of left flank pain. A "stone series" CT scan of his abdomen and pelvis was done. Roe Radiologist appreciated a 2 mm renal calculus but did not appreciate a 2 cm para-aortic mass. Several days later, the plaintiff did pass a kidney stone, however, his left flank pain persisted.

On Jan. 25, 2009, the plaintiff presented to the same emergency room. A stone series CT of the pelvis and abdomen was ordered and read by a different radiologist, also a defendant. He also failed to appreciate the 2 cm para-aortic mass. The plaintiff's pain persisted. His primary care physician managed the pain with narcotic medication.

In late June 2007, the plaintiff and his family relocated to Pensacola, Fla. Upon arrival, he presented to an emergency room because of the increasing pain. A CT scan revealed the presence of a 7 cm mass. Biopsy revealed the presence of an extra-skeletal Ewing's sarcoma, a rare pediatric cancer.

Aggressive chemotherapy was undertaken, followed by radiation. The plaintiff then underwent surgery in March 2008 where 2 mm of residual tumor was found. He underwent further chemotherapy, and was re-imaged in October 2008. At that time, a recurrent tumor was found. He has since developed metastatic disease to the liver.

PLAINTIFF'S CONTENTIONS:
The plaintiff contended that accepted standards of care required that both radiologists appreciate the presence of the soft tissue retroperitoneal para-aortic mass. Had they done so, it is likely that, with a 2 cm primary, that plaintiff could have increased long-term disease free survival. As a consequence of the dramatic increase in the size of the tumor, the plaintiff has suffered from recurrent disease, the prognosis for which is poor.

DEFENDANT'S CONTENTIONS:
The defendant contended that although the lesion is present on the two CT scans, it is a subtle finding, which even the defense expert missed on his first review of the films. Moreover, they argued that, due to the proximity of the lesion to the aorta and inferior mesenteric artery, the plaintiff's prognosis would have been poor whether the diagnosis had been made in January or July 2007.

Damages

The plaintiff worked as an analyst for PacifiCare, earning $95,000 annually.

Injuries

Progression and likely death from Ewing's sarcoma.

Result

The case settled for $900,000 at mediation with Jay Horton from Judicate West on Aug. 21, 2009.