Facts

Marlene Iverson, then 67, presented to dermatologist Dr. Feibleman's office on July 10, 2001 allegedly complaining of a black streak under her right thumbnail. The chart note from that visit indicates "thumb-fungus?" There were no vistis which addressed the right thumb until 15 months later in October 2002.

From October 2002 through June 2003, Dr. Feibleman treated warts that recurred and multiplied on the plaintiff's right thumb. In July 2003, Dr. Feibleman referred the plaintiff to a hand surgeon due to a pigmentation contained under her right thumbnail. The hand surgeon performed surgery and it was determined that the plaintiff had a subungual melanoma under her thumbnail and a 6mm lesion in the volar pad of her right thumb. She had a 4mm metastatic axillary sentinel node as well. She ultimately developed metastases to both her liver and lungs as well as other intransit metastases. She is terminal.

PLAINTIFF'S CONTENTIONS:
Plaintiff contended that Dr. Feibleman was negligent in not appreciating the significance of the black streak under the plaintiff's right thumbnail on July 10, 2001. Additionally, plaintiff alleged that he should have ordered that the plaintiff return so that he could follow up with respect to this clearly abnormal finding. Plaintiff also argued that Dr. Feibleman negligently treated the tumor in the volar pad of the right thumb which he mistakenly believed were warts.

Plaintiff alleged an approximate two-year delay in diagnosis. Plaintiff's current treater, Dr. Peter Baosberg, testified that had the diagnosis been made in July 2001, to a reasonable degree of medical probability the tumor had not metastasized and the plaintiff would have had a significantly better chance for cure and a prognosis much better than 50 percent.

DEFENDANT'S CONTENTIONS:
Defendant contended that plaintiff never presented with a black streak under her right thumbnail or he or his medical assistant would have charted it in the 11 visits that she had with him between July 2001 and July 2003. Defendant also contended that the patient's melanoma, when diagnosed, was amelenoatic, i.e., without pigment and therefore, this could have never presented as a black streak that he allegedly missed.

Finally, Dr. Feibleman contended that given the aggressive nature of subungal, amelanotic lesions and given the bad prognostic features of this tumor including absent tumor infiltrating lymphocytes and no evidence of regression, this tumor metastasized prior to July 2001 rendering her diagnosis in July 2001 as a stage 3c and her prognosis less than 50 percent.

Result

Defense verdict.

Deliberation

4 hours over two days

Length

seven days