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A Piece of My Mind
September 3, 2003

A Difference of Degrees

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Editor.

JAMA. 2003;290(9):1135-1136. doi:10.1001/jama.290.9.1135

As one of the faculty who oversee the medical-legal curriculum for first- and second-year medical students at the University of Minnesota Medical School, I was impressed by the reaction of a group of first-year students to a medical malpractice case we were discussing.1 The case involved a physician who noticed a breast lump in the course of his examination of a patient. He told her it was a "fibrous mass" and not to worry about it, never ordering any imaging or other diagnostic testing. Several years later, the physician again noticed the lump, but still disregarded further evaluation. He then retired, and the patient saw a different physician 15 months later. This time, her new physician noticed the suspicious lump and immediately ordered a mammogram. A subsequent biopsy determined that the mass was cancerous and that the cancer had metastasized to four lymph nodes. The tumor was then excised, and the patient underwent chemotherapy. She then sued the first physician for medical malpractice, claiming damages for having to undergo chemotherapy and a decreased chance of survival because of the delayed diagnosis.

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