Delay in Diagnosing Lung Cancer

The Ripley Case

This case was about a PCP who ordered annual chest x-rays for his patient, Louise Ripley, a 73-year old retired nurse who was concerned with potential lung cancer.

In 2005, the annual chest x-ray report revealed the early stages of lung cancer and the report recommended follow-up testing. The doctor however, neglected to tell Ms. Ripley anything about this report, and more importantly, neglected to order any follow-up testing as recommended.

12-months later, the next annual chest x-ray again revealed the lung cancer. It also revealed that the cancer spread and tripled in size from a year earlier. As a result, a simple curative lobectomy – which is surgically removing the small section of the lung which contained the cancer - was out of the question. Since the cancer spread and tripled in size during this one-year delay, Ms. Ripley instead had to receive extensive chemotherapy treatment and multiple surgeries to remove more portions of her lung. Most importantly, Ms. Ripley then lost a substantial chance of cure.

Prior to the scheduled jury trial, Ms. Ripley was scheduled for a VATS surgical resection and brachytherapy since the tumor began to again increase in size. Fearing that Ms. Ripley would not fully recover from this procedure, we took Ms. Ripley’s videotaped deposition to preserve her testimony for trial. Tragically, the videotaped deposition was needed as Ms. Ripley passed away from complications related to the surgery.

Since Ms. Ripley made it clear to her family that she wanted the lawsuit to proceed in the event of her death, on behalf of Ms. Ripley’s Estate, we continued the trial, amended the lawsuit, and converted the lawsuit to a Wrongful Death and Survival Action case.

Shortly before the new trial date, all parties agreed to waive the jury trial and submit to a Binding Arbitration proceeding. In a binding arbitration proceeding, the parties present a shortened version of their case before a neutral third-party arbitrator, in this case a former Allegheny County Court of Common Pleas Judge. Since it was “binding”, the parties agreed that the arbitrator’s decision would be final and could not be disputed or appealed.

Although the defendant doctor admitted that he was negligent in failing to follow-up on the results of the chest x-ray, his lawyer presented a “causation defense” and argued that Ms. Ripley’s ultimate outcome would not have changed even had the doctor given proper care. Conversely, our expert oncologist testified the doctor’s negligence eliminated Ms. Ripley’s opportunity to undergo a curative lobectomy before the cancer tripled in size and further opined that the delay in diagnosis led to a clinical course that required more invasive interventions that ultimately caused Ms. Ripley’s premature death.

After three-days of testimony, the arbitrator found in favor of Ms. Ripley’s Estate and awarded it a substantial sum. Ms. Ripley is survived by three sons and numerous grandchildren.