Sometimes the Pathologist is Right
A pathologist is a physician who examines tissues, checks the accuracy of lab tests, and interprets the test results in order to facilitate the patient’s diagnosis and treatment. They often play a very important role in the correct diagnosis and treatment of patients…they just operate behind the scene and I recently read a case report which highlights the important role of pathologists.
An elderly female patient consulted a plastic surgeon for the removal of a basal cell carcinoma on her nose. The plastic surgeon removed the lesion and sent a tissue specimen to a pathologist for analysis. The pathologist determined the plastic surgeon had failed to remove all the cancer (margins of tissue were not clear of cancer) and reported his findings to the plastic surgeon. Unbelievably, the plastic surgeon disagreed with the pathologist’s findings and apparently told the patient he was correct (all the cancerous tissue had been removed), the pathologist was wrong, and the patient accepted the plastic surgeon’s story.
Eighteen months later the patient notice a redness at the excision site on her nose. A biopsy was performed by a dermatologist, who recommended Mohs micrographic surgery. As a result of the surgery, the elderly woman lost all of the skin on her nose, required four reconstruction surgeries, and now is scarred and disfigured.
The patient sued her plastic surgeon alleging he failed to remove all of the cancer during his surgical procedure and failed to listen to the pathologist’s advice or retain another pathologist to review the tissue slides and provide a second opinion. The jury found the plastic surgeon was negligent and awarded the patient $400,000 in damages.
As patients we almost never meet or see the pathologist but their role can be huge.