Prostate cancer is a terrible disease. Even if not 100% accurate there are diagnostic tests that assist doctors to identify when the cancer is present in a patient. However as a consequence of the chance of false negatives (a negative test outcome even though the patient actually has cancer) doctors must follow up and redo tests as appropriate when patient complaints and screening tests continue to signal the possibility of cancer. Not doing so might give rise to a lawsuit for medical malpractice.

In one documented claim a patient communcated to his primary care physician that he was experiencing urinary frequency and burning. The doctor commenced the patient on antibiotics and refered him to a urologist. The urologist conducted a cystoscopy which revealed that the individual had an enlarged prostate. The urologist also did a PSA blood test which came back a 16.3 (a result above a 4.0 is generally considered to be elevated). Because of that the urologist did a biopsy 2 months later. The biopsy was interpreted by a pathologist as showing no sign of cancer.

The subsequent year the individual returned to the urologist. Now the PSA blood test was a 2.9 (normally regarded as in normal range). The urologist diagnosed the patient with BPH (a noncancerous enlargement of the prostate). After 3 months the man consulted the PCP for fever and nocturia (needing to urinate during the night). The physician began him on another round of antibiotics. A follow up urine culture came back negative. The primary care physician hence referred him to the urologist. The urologist took a PSA test which registered a 6.4 ( high).

A biopsy analyzes samples of the prostate. Therefore, a biopsy might not catch the cancer. Yet, the urologist chose to depend on the prior year’s biopsy and to not perform another one as a follow up. Instead, the urologist failed to follow up on the patient's complaints and high PSA. The subsequent year the patient went back to his primary care physician. His symptoms continued to include nocturia. On physical examination the doctor noted that the patient had a highly enlarged prostate. Nevertheless, the physician failed to order a PSA or re-refer the individual to a urologist. Regular blood testing four months subsequently showed that the man’s PSA was at 7.4 Neither doctor did anything to follow up.

One more year goes by at which time the family doctor noted that the PSA level was 9.8 Once more, no follow up or referral to a urologist. Still an additional year and the patient is still complaining of nocturia. This time the PSA was 9.7 No follow up and no referral. On the fifth yea following the man’s first claims of urinary problems the primary care physician again recorded a substantially enlarged prostate gland and a PSA level that had reached a 31. The physician at last refered the patient back to the urologist.

The urologist confirmed that the patient’s prostate was enlarged and started the man on 2 weeksafter which he would do an additional PSA test. When the PSA test was repeated 2 weeks later it showed a 33. A biopsy followed which uncovered cancer every sample taken.

Testing subsequently revealed that the patient had cancer metastasis to the lymph nodes, the liver and the bone. Regardless of a course of hormone therapy and radiation therapy the man died roughly 18 months after his diagnosis. The law firm that handled this matter announced that a settlement in the amount of $1,000,000 was attained in the case.