Medical Malpractice Case for the Failure to Diagnose Gastric Cancer Settles after Woman’s Gastric Cancer goes Undetected

By February 13, 2008 Medical Malpractice

A lawsuit filed against a doctor who, despite his patient’s symptoms, failed to order a medical test that would allegedly have detected gastric cancer when it was still treatable has been settled for a confidential amount.
Attorneys Jeffrey J. Lowe of Carey, Danis & Lowe represented the woman’s family.
On Jan. 8, 2002, Panagiota Yiatras, 65, was examined by Dr. Miguel Cannon, her primary-care physician. She told Cannon that she had been tired for about a month and had lost three pounds since the previous fall. Cannon referred her to a gastroenterologist at Gateway Gastroenterology Inc. in St. Louis County, for a colonoscopy.
Nine days later, Yiatras with the gastroenterologist and complained that she had been bloated for the past month and explained that she had now lost five pounds. The colonoscopy was performed on Jan. 18, 2002, at St. John’s Mercy Medical Center. The hospital’s records indicate that Yiatras’ health complaints were weight loss, nausea and abdominal pain. The admitting history indicated that Yiatras complained of weight loss, stomach upset, heartburn and pain.
During the colonoscopy, a noncancerous polyp was discovered. In the report of the colonoscopy, the gastroenterologist noted that the patient’s chief complaint was abdominal bloating and that she believed that she had lost five pounds. He diagnosed gastroesophageal disease and recommended treatment with a proton-pump inhibitor.
On Jan. 29, 2002, Yiatras met with her primary-care physician to discuss the polyp, and he recommended that she undergo another colonoscopy in three years. In July 2003, though, it was discovered that Yiatras had metastatic gastric cancer that had progressed to stage IV, the final stage. She died in March 2005.
Yiatras’ husband and adult children filed a suit alleging wrongful death and medical malpractice against Gateway Gastroenterology Inc. in St. Louis County Circuit Court on Aug. 26, 2005. The family alleged that the gastroenterologist negligently failed to recommend Yiatras have an upper endoscopy, which would likely have revealed the cancer.
According to plaintiffs’ expert Dr. Meyer Solny, a board-certified gastroenterologist, Yiatras had dyspepsia, defined as chronic or recurrent pain or discomfort in the upper abdomen. Whenever a patient older 45 reports dyspepsia and weight loss, according to the standards of the American Gastroenterological Association, an endoscopy should be performed. The American Society for Gastrointestinal Endoscopy sets forth similar recommendations for patients older than 45 who experience dyspepsia and weight loss.
An oncologist expert for the plaintiffs, Dr. Robert Sklaroff, opined that, judging from Yiatras’ symptoms, in January 2002 the gastric cancer would have been at stage I or IA, which carries a survival rate in excess of 50% at five years. It was his opinion that if the cancer had been discovered in January 2002 Yiatras would likely have survived.
The defendant denied the allegations. They asserted that at the time the colonoscopy was performed Yiatras did not have dyspepsia and a 5-pound weight loss was not significant enough to warrant an upper endoscopy. It was the opinion of the defendants’ oncology expert that she had either stage II or stage III gastric cancer. The survival rate for stage II or stage III cancer is less than 50 percent, and the five-year survival rate for stage III cancer is 8 percent.
The case was referred to mediation. The parties entered into a confidential settlement on Aug. 10, 2007. The defendant did not admit liability.