Facts

Milton Morris was referred to Dr. Stephen Hankins, an orthopedic surgeon and upper extremity specialist, for a recurrent infection and lesion of the fingernail and his left index finger. Hankins performed a surgery on Morris for debridement and ablation of the germinal nail matrix. He did not submit the tissue removed during the procedure to pathology. Morris claimed that Hankins believed the recurrent lesion was caused by an abnormal nail growth.

Morris was seen by another upper extremity specialist due to ongoing and similar complaints two years later. Another debridement was performed, and a specimen was submitted to pathology which revealed cancer. Morris was diagnosed with subungual amelanotic malignant melanoma. Subsequent testing revealed metastasis of the melanoma to the axillary nodes. He was diagnosed with Stage III disease.

Morris sued Hankins for medical malpractice for the delayed diagnosis due to Hankins' failure to submit the tissue surgically for pathological examination. Morris' history included trauma to the area for a sliding glass door approximately eight years prior, and that his X-ray was negative and he had undergone a series of antibiotics and antifungal medications that did not resolve the lesion prior to seeing Hankins.

Morris claimed that Hankins failed to meet the standard of care, which required Hankins to submit the surgically removed tissue to pathology. This would have revealed the specimen to be positive for a Stage I disease, that could have been treated early on. An early diagnosis would also have avoided the need for subsequent surgical procedures including removal of the entire index finger and a portion of Morris' hand. An early diagnosis would also have avoided metastatic disease and Morris would have had a better long-term prognosis. His expert testified that metastasis probably occurred during the two-year delay and that Morris' five-year survivability decreased from 90 percent to less than 50 percent during this time.

An orthopedic oncology expert testified in Hankins' behalf that the care and treatment Morris received was in keeping with the standard of care and given the historical information and clinical presentation, the possibility of neoplasm did not rise to a sufficient index of suspicion to require pathological evaluation. Hankins also claimed that Morris' current five-year survivability was greater than 75 percent.

DEFENDANT'S CONTENTIONS:
Defendant contended that a mechanical nail deformity explained the condition and due to the history of trauma further testing was not indicated.

Damages

Morris sought $38,000 in lost wages and minimal out-of-pocket expenses.

Injuries

Morris underwent a series of lymph node biopsies and amputations of the digit.

Result

The jury returned a verdict in favor of defendant.

Deliberation

30 minutes

Poll

12-0

Length

seven days