The 77-year old patient was admitted to a hospital in Dutchess County, New York with complaints of a chronic cough.  A CT angiogram of the chest revealed multiple soft tissue masses in the mediastinum (the central party of the chest).

A pulmonologist saw the patient in the hospital and followed up with him in his office following the patient’s discharge from the hospital. The pulmonologist informed the patient and his family that the multiple soft tissue masses in the mediastinum were “nothing to worry about.”  The pulmonologist initially planned to refer the patient to a thoracic surgeon to evaluate the mediastinal masses, but the referral was not made.

7 ½ months later, the patient’s respiratory complaints worsened.  Imaging studies revealed that the mediastinal masses had doubled in size and spread to the diaphragm.  A biopsy revealed a diagnosis of pleomorphic sarcoma (a type of cancer of the soft tissues), and an operation was performed to remove the malignant tumor from the mediastinum. The patient died from complications relating to the pleomorphic sarcoma 5 months after the surgery.

The contention in the lawsuit was that the pulmonologist had an obligation to either refer the patient to a thoracic surgeon or order follow up imaging and/or biopsy to evaluate the mediastinal masses.  The failure to work up and evaluate the mediastinal masses was a deviation from the standard of care.  As a result of the delay in diagnosis, the cancer spread from the patient’s mediastinum to his diaphragm.

The patient was survived by 2 adult daughters.