Problem: UNTIMELY DIAGNOSIS In 1987, the patient-plaintiff in Follett v. Davis 23 had her first office visit with Dr. Davis. In the spring of 1988, the plaintiff discovered a lump in her right breast and made an appointment to see Davis. The clinic had no record of her appointment. The clinic's employees directed her to radiology for a mammogram. Neither Davis nor any other physician at the clinic offered the plaintiff an examination. In addition, she was not scheduled for a physician's examination as a follow-up to the mammogram. A technician examined the plaintiff's breast and confirmed the presence of a lump in her right breast. After the mammogram, clinic employees told her that she would hear from Davis if there were any problems with her mammogram. The radiologist explained in his deposition that the mammogram was not normal. Davis received and reviewed the mammogram report and considered it to be negative for malignancy. He did not know of the new breast lump because none of the clinic employees had informed him about it. The clinic, including Davis, never contacted the plaintiff about her lump or the mammogram.

On April 6, 1990, the plaintiff called the clinic and was told that there was nothing to worry about unless she heard from Davis. On September 24, 1990, the plaintiff returned to the clinic after she had developed pain associated with that same lump. A mammogram performed on that day gave results consistent with cancer. Three days later, Davis made an appointment for the plaintiff with a clinic surgeon for a biopsy and treatment. She kept her appointment with the surgeon. Nevertheless, this was her last visit with the clinic, as she subsequently transferred her care to other physicians. In October 1990, the biopsy confirmed the diagnosis of cancer. In August 1992, the plaintiff filed a lawsuit. The evidence showed that after the patient found a lump in her breast, she went to Davis, her regular obstetrician/gynecologist, and to the clinic for aid. Davis and the clinic, through the clinic's employees and agents, undertook to treat her ailment. That undertaking ended when the clinic's surgeon performed the biopsy and therefore was continuous in nature. The evidence demonstrated that had clinic procedures been followed, Davis or another physician at the clinic would have had occasion to make a more timely diagnosis.

Ethical and Legal Issues

1. Describe the ethical and legal issues presented in this case.

2. Describe how similar incidents can be prevented in the future.