By Correy E. Stephenson Staff writer Published: February 12, 2009
The family of a Nevada woman was awarded $2.5 million after her doctor failed to correctly diagnose her with rectal and colon cancer, leading to her death at age 27.Elisa Sanchez was 24 years old and had just given birth to her first child when she visited Dr. Steven Lampinen, complaining of rectal bleeding.The doctor diagnosed hemorrhoids without performing an exam, and despite repeated visits by Sanchez over the next seven months, never ordered a colonoscopy or further tests. After a visit to the emergency room, Sanchez was diagnosed with colon and rectal cancer and died in 2007.Steven J. Karen, a sole practitioner in Henderson, Nev. who represented Sanchez’s family, argued that if Elisa had been correctly diagnosed at her initial visit, she would have had a 97 percent chance of survival. Instead, the delay reduced her chances to about 50 percent, he told Lawyers USA.Scott Cook, a partner at Gordon & Rees in Las Vegas who represented the defendant, did not respond to a request for comment.Multiple appointments, missed chances Elisa Sanchez gave birth in November 2003. She had a routine vaginal delivery with no complications, Karen said, and was released the next day after a normal vaginal exam.But about a month later, she started noticing blood in her stool and experiencing tenesmus, a feeling of incomplete defecation.
In April 2004, she first visited Lampinen. At that visit, he noted in the chart that Sanchez was suffering from constipation and other pain and finding bright red blood in her stool.But Lampinen did not perform an exam, suggest a follow-up appointment or make a referral to a specialist, Karen said. Instead, he told Sanchez she had hemorrhoids and suggested she use an over-the-counter laxative.Sanchez’s symptoms continued to worsen and she returned to the office in August, when she saw a nurse, Brian Bishop. He performed a digital rectal exam and found a palpable mass within the range of his index finger, Karen said, telling Sanchez it was an internal hemorrhoid.Failing to perform a visual exam to confirm his diagnosis was a “big mistake,” Karen noted. “All the medical texts state you cannot diagnose an internal hemorrhoid simply by feeling it without visualization.”At trial, “I asked [the nurse] how he could feel the difference between a hemorrhoid and cancer, and his answer was that he didn’t know – he had never felt cancer before,” Karen said. “But there he was, feeling the cancer and calling it a hemorrhoid.”Sanchez made two more trips to the office, seeing both Nurse Bishop and Dr. Lampinen and receiving the same diagnosis: hemorrhoids.
She was treated with an enema and told to use Preparation H and take a sitz bath.During the bath, Sanchez herself felt the tumor vaginally and went to the emergency room. She then had a colonoscopy and was diagnosed in early December with rectal and colon cancer.Sanchez underwent chemotherapy and radiation as well as major surgeries, including having her entire colon, vagina and uterus removed, and having her anus sewn completely shut, but she died in 2007.Odds of survivalIn order to establish that Sanchez would have had a high rate of survival had her cancer been detected sooner, Karen relied upon a clear timeline.Because there was no detectable tumor in the vagina when Sanchez gave birth in November, Karen was able to establish that the tumor grew from the rectum – where Nurse Bishop palpated it the following August – into the vagina, where Sanchez felt it.Karen also relied upon a study that was published in September 2008 that established survival rates for various stages of these types of tumor.Based on the lack of tumor in November and the symptoms Sanchez displayed at her first appointment in April, Karen’s expert told the jury she was a stage 1 or possibly early stage 2 when she had her first appointment with Dr. Lampinen.
The study reported that stage 1 patients had a 97 percent chance of survival while stage 2 had an 84 percent chance.When Sanchez was finally diagnosed in December of that year, her odds had dropped to 50 percent.No settlement offersAt trial, Karen presented a four-hour video of Sanchez that she made prior to her death. In addition, her mother testified about how much she missed her daughter and what it was like to watch her die.Karen said the eight-person jury was unanimous in their decision and deliberated for only a few hours before reaching its verdict of $2.5 million – $2 million in economic damages, $250,000 for pain and suffering and $250,000 to her husband and daughter for future pain and suffering.Despite the jury’s quick return, Karen said the doctor’s insurance company never made a single settlement offer, even after two court-mandated settlement conferences.”We offered to settle for the doctor’s insurance policy limits on multiple occasions, which was only $1 million,” he said. “But they insisted on taking it to trial.”Questions or comments can be directed to the writer at: [email protected]’s attorneys: Steven J. Karen of the Law Office of Steven J. Karen in Henderson, Nev. and Clark Seegmiller and Kurt D. Anderson of Seegmiller & Associates in Las Vegas, Nev.Defense attorneys: Scott Cook and Joan Foy of Gordon & Rees in Las Vegas.
The case: Family and Estate of Elisa Sanchez v. Lampinen; Jan. 29, 2009; District Court, Clark County, Las Vegas, Judge Jennifer P. Togliatti.
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