The patient was a 53-year-old male who presented to an internal medicine practice because he had a lump in his right groin. The patient had been going to the practice for years and typically
The patient was a 53-year-old male who presented to an internal medicine practice because he had a lump in his right groin. The patient had been going to the practice for years and typically saw one physician assistant (PA) for most appointments. Over the years, he had seen the PA for various conditions, such as allergies, abdominal pain, cardiac issues, respiratory infections, and hypertension, among others.
At the patient’s visit to evaluate the lump in his groin, the PA ordered a CT scan. The test was completed, and the results showed an enlarged inguinal lymph node. Whether these results were communicated to the patient is unclear; although receipt of the results was documented in the patient’s record, no documentation from that time indicates whether the patient was notified about the results or next steps.
At the patient’s next office visit with the PA, 2 months later, the electronic health record (EHR) system was down, and the patient’s chart was not available for review. During that visit, the patient did not mention the groin mass to the PA. Several more visits to the PA occurred over the next 10 months, but the lump was never discussed.
A little more than a year later, the patient returned to the internal medicine practice, but saw another PA at that appointment. The PA noted that the groin mass was now painful and had increased in size. The patient was referred to a general surgeon, who performed a biopsy on the enlarged inguinal lymph node. Ultimately, the patient was diagnosed with Stage III Hodgkin lymphoma.
Following the patient’s diagnosis of Hodgkin lymphoma, the PA at the internal medicine practice added a note to the patient’s health record stating that she had told the patient about the CT results 2 years earlier, and instructed him to follow up with a general surgeon. The patient refuted that fact and filed a malpractice suit against the PA and the supervising physician alleging delayed diagnosis.
What did the PA do wrong in this scenario? Please list things you believe the PA did wrong or should have done in this scenario. Did their actions break any laws? Is the patient at any fault?
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