A malpractice verdict in Florida

Yesterday a Broward County Jury awarded the family of Janet Pandrea 8.1 million dollars. Mrs. Pandrea died in 2001 at the age of 65 after being treated for a cancer she had been wrongly diagnosed having.

The Miami Herald article can be found at- http://www.miami.com/mld/miamiherald/11859778.htm

Three years after his wife's death, Chuck Pandrea still hugs the dresses she left hanging in her closet.

''Just to smell her and pretend like she was there,'' he said.

Janet Pandrea, 65, died in April 2002, three months after she visited her doctor for a cold. The Coconut Creek grandmother was misdiagnosed and treated for cancer, a disease all the doctors and lawyers now agree she never had.

Her family sued her doctors and the hospitals who cared for her. On Wednesday, after a seven-week trial, jurors in Fort Lauderdale awarded the Pandreas $8 million in damages.
Lawyers representing two of the doctors involved in the case say they will appeal the verdict. It was unclear whether a third doctor would appeal.

In January 2002, Janet Pandrea went to see her family physician, Dr. Martin Stone, for a lingering cough. Stone ordered a chest X-ray, which revealed a mass in her chest, so the doctor ordered a needle biopsy.

Dr. Peter Tsivis, a pathologist from Coral Springs Medical Center, admitted during trial that he misdiagnosed her with malignant non-Hodgkin's lymphoma.

Stone referred Pandrea to oncologist Abraham Rosenberg, who began treating her with chemotherapy. She died a few months later of complications stemming from her treatment, according to court documents.

During trial, the couple's youngest son, Perry Pandrea, described his mother's last moments:
'We were holding her hands. `Please don't die -- fight -- do whatever you can.' [We were] all huddled around,'' he said. ``We were just in shock . . . no one told us that Mom was going to die.''

After her death, the family hired Dr. Mark Shuman, a pathologist from the Miami-Dade County Medical Examiner's Office. He told them that Pandrea never had cancer, but rather a benign tumor that could have been simply removed.

That much is no longer in dispute.

Where to cast the blame is.

The jurors laid half of the blame on the oncologist, Dr. Abraham Rosenberg. The plaintiffs' lawyers contended he ordered a follow-up test but failed to check the results.

But Bob Cousins, Rosenberg's attorney, said the pathologist, Tsivis, was to blame.
''That subsequent test was not important for the diagnosis,'' Cousins said. ``The follow-up test was not driving the decision to treat her.''

Rosenberg, his lawyer said, ``was acting on good faith and relying on the diagnosis of the pathologist.''

According to an article at Sun Sentinel.com Mr. Cousins also said.

"It is difficult for many jurors, many people, to be able to set aside emotions and sympathy in deciding a case such as this," Cousins said."I think in retrospect the [state] Legislature demonstrated a lot of wisdom when they enacted caps for pain and suffering."

It's easy for you to say Mr. Cousins. You didn't have a family member die because of medical incompetence. There is no question in this case about what happened. Your client killed someone without thinking twice if what they were doing was right for this patient.

Coral Springs Medical Center, which employed Tsivis, was named in the suit, but Tsivis was not.

Cousins said he believes the plaintiffs' lawyers didn't focus their case on Tsivis or the medical center because, as part of the North Broward Hospital District, Coral Springs Medical Center has a $200,000 cap on damages in medical malpractice awards.

''That's absolutely false,'' said Mike Ryan, who tried the case for the family, along with Scott Liberman. ``Dr. Rosenberg was the only one who made the decision to treat her.''

During the trial, Tsivis acknowledged that he misread the slide from Pandrea's biopsy.

''We believe it was this honest and forthright admission that resulted in the verdict returned by the jury finding the North Broward Hospital District minimally responsible,'' said Trish Power, an NBHD spokeswoman.

Jurors divvied up the share of negligence as follows: Rosenberg, 50 percent; Coral Springs Medical Center, 10 percent; Stone, 12 percent and the University Hospital, where nurses monitored Pandrea's illness, 28 percent.

Liana Silsby, a lawyer for Stone, said jurors were ''swayed by the obvious sympathy factors in the case'' and had trouble remaining objective.

''Dr. Stone was not involved in the misdiagnosis of cancer or in the decision to start chemotherapy,'' Silsby said.

Sorry Ms. Silsby, Dr. Stone is involved in this case. Maybe if he had asked questions instead of accepting someone else's diagnosis Mrs. Pandrea would still be alive. Dr. Stone didn't take the time and someone died.

My heart goes out to the Pandrea family. They won in court, but I make a bet it feels incredibly hollow to all involved. A wife and mother is gone and no money can ever bring her back.

I do want to comment on pathologists and cancer diagnosis. This comes from my own experience as a nearly 12 year survivor of the deadliest skin cancer, malignant melanoma or MM for short.

It was late 1993 when I was first diagnosed. To say it was a shock is an understatement. A large mole had been taken off my back two weeks earlier and I wasn't concerned. Then that day 12-30-93 Dr. Rubenstein was telling me I had cancer.

1994 saw me spend much of the year going from one specialist to another. Before year end three more MM were found on my body. One more on my back, one on my face, one on my left upper arm. See I have what is known as dysplastic nevi syndrome. Moles are all over my body. A dermatologist really has to examine me very extensively at my appointments.

I got quite an education about MM in 1994 and the years since. Part of this education was about pathology reports and how to read the results at least in case of dermopathology. If you ever been a cancer patient or a suspected cancer patient, some of the worst times are when you have to wait for results. It would drive me crazy sometimes.

What puzzles me in this case, is why no second opinion was ever done after the original diagnosis. I know in each and every instance of my 4 MM and at least another ten of the 30 or 40 Dys. Nevis I had removed, were seen by at least two pathologist/dermopatholist. Some of them were seen by up to three. Or even in a few cases reviewed by two of the best in the country, Dr. Ackerman in Philadelphia and another the name evades me who was at Yale or Harvard.

There was one time I had a mole removed in 1996. It was seen by Dr. #1 who thought it was dysplastic, he sent it for another opinion and Dr. #2 said it was melanoma. He then sent for a 3rd opinion from Dr. Ackerman who said it wasn't MM or dysplastic at all. This episode was really trying for me because I waited 10 days to get the final or 3rd report.

This episode like what happened with Mrs. Pandrea leaves me questioning how good is the work done by these pathologists. Are these men or women so overworked they can't tell the difference between benign and malignant? Why don't they have someone at the same lab double check. I guess the labs want to save money and get as many results out as possible, but with so much potentially at stake, I would think some caution would be needed instead of watching bottom lines. Yes the world is often run by bean counters.

That's just my opinion based on my experience as a cancer survivor. God bless the melanoma warriors.