Delayed Diagnosis of Renal Cell Carcinoma

The Weller Case

Communication errors are a major cause of poor quality care, patient harm, and medical malpractice. Doctors need to communicate with other doctors, nurses and staff members in a clear way in order to provide competent care. They also need to communicate properly with patients. Physician communication errors can oftentimes have devastating consequences, as was in the Weller Case.

In this case, we represented Sarah Weller in a suit against the Defendant emergency room doctors and Defendant Hospital for failing to timely diagnose kidney cancer. Due to the Defendants’ negligence, Mrs. Weller’s diagnosis for kidney cancer was delayed by over 2 years allowing significant growth of the tumor.

Mrs. Weller presented to Defendant Hospital with lower left abdominal pain, constipation, nausea and “kidney pain.” The Defendant ER Doctor ordered a CT of the Abdomen and Pelvis with contrast for further evaluation of Mrs. Weller’s complaints. The Hospital’s radiologist reviewed the images and reported that Mrs. Weller had “a solid mass in the lower pole of the left kidney concerning for renal cell carcinoma.” The CT Scan report also discussed findings of diverticulitis. The CT Scan report was given to the emergency room doctor. Mrs. Weller was never told about the tumor concerning for renal cell carcinoma. This was a critical communication error. She was diagnosed with diverticulitis and discharged from the emergency room.

Three days later, Mrs. Weller returned to Defendant Hospital’s emergency room with complaints of being unable to move bowels and abdominal pain. This time, Mrs. Weller was seen by another ER doctor. This ER doctor saw that she had a CT scan just days prior and instead ordered an x-ray of the abdomen. Once again, this ER doctor failed to communicate with Mrs. Weller about the tumor concerning for renal cell carcinoma. She was discharged from the ER with a diagnosis of constipation and diverticulitis – no mention of the tumor seen on the CT Scan.

Two years later, Mrs. Weller, for the third time, went to the Defendant Hospital’s emergency room with severe vomiting and shaking. This ER doctor ordered another CT of the abdomen and pelvis revealing a much larger mass in the lower pole of the left kidney as well as enlarged lymph nodes at the level of the renal hilus. The ER doctor told Mrs. Weller that there was large tumor of the kidney that had grown significantly since two years prior. This was the first time anyone advised Mrs. Weller about the tumor – two years after it was first seen on imaging.

Mrs. Weller was diagnosed with stage III renal cell carcinoma with rhabdoid features. She underwent a left radical nephrectomy with retroperitoneal lymphadenectomy at UPMC Shadyside. Because of the two year delay, Mrs. Weller had to undergo a more complex surgery in an attempt to remove all of the cancer.

A lawsuit was filed in Mercer County, Pennsylvania against the defendants seeking damages for allowing Mrs. Weller’s cancer to grow, multiply, and metastasize, thus increasing the risk of serious illness and death.

This case was resolved for a 7-figure settlement prior to trial.

This case illustrates the importance of communication, both in the physician-patient relationship and in the relationship between the physician and other members of the treatment team such as hospital emergency departments, nurses and radiologists. Effective communication in health care can make a life-or-death difference.