It is easy in this Hallmark, holiday driven world to get caught up in celebrating something or someone on its designated day. But we should not forget them the rest of the year either. That is certainly true for celebrating and appreciating veterans.
We practice law out of Roanoke, Virginia. That means it would be easy to focus on what is happening medically by reference to the two largest hospital chains around Roanoke – Carilion Clinic and LewisGale (owned by HCA). But there is another hospital in our area that serves many of our local veterans – the Salem VA.
Many of us have heard about the troubles the VA system has had nationally – long wait times, bad care, retaliation against whistleblowers trying to bring VA problems to light, etc. Our local Salem VA is also not perfect.
We recently settled a VA medical malpractice case that involved the wrongful death of a 49-year old veteran. Here is a brief summary of the facts:
The veteran was a patient of the Veterans Affairs Medical Center from late 2011 through his death from cancer in June 2013. He sought care beginning in December 2011 for thyroid-related symptoms, including a prominent goiter.
As part of the workup for his thyroid, in early 2012, the veteran underwent a thyroid scan and ultrasound. The thyroid scan revealed a large “cold nodule.” While hot nodules are almost always not cancerous, some cold nodules are cancerous. The thyroid scan alone cannot distinguish between a benign and malignant cold nodule.
After receiving the radiology reports, his doctors did not order a biopsy of the cold nodule or otherwise rule out cancer. Instead, he was medically managed for hyperthyroidism for about 15 months.
In May 2013, the patient presented to the Emergency Department because his thyroid mass began rapidly growing in size. He was admitted and, shortly after his admission, diagnosed with metastatic thyroid cancer. He had two types of thyroid cancer – one non-aggressive type with near 100% survival rates and a second aggressive type that can develop from the less aggressive and has high mortality rates. By that point, the patient was not a surgical candidate. He received palliative care until his death about a month later at age 49.
He was the primary provider for three statutory beneficiaries – his wife, step-daughter, and step-granddaughter.
Our experts on standard of care opined that the defendant’s employees were negligent in failing to order a biopsy of the patient’s thyroid mass once the cold nodule was discovered. Our medical experts would have testified that had a biopsy been timely performed, the cancer would have been diagnosed and could have been successfully treated.
The defense offered no standard of care experts. The defense causation expert opined that earlier diagnosis and treatment of the thyroid cancer would not have materially changed the outcome because he had the aggressive form of thyroid cancer all along. In part based on this causation theory, the defense offered an expert economist who offered a much lower value of the veteran’s lost wages and services as compared to the $800,000 proffered by our economist.
Suit was filed and extensive discovery undertaken. The case settled a few days before trial for $1,000,000.
Medical malpractice cases are generally hard fought, expensive, and time consuming. That is just as true for medical malpractice cases that come out of VA facilities. The reward for success in these cases is largely measured by knowing we are doing right by veterans and their families.