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On January 20, 2017, the Superior Court of Pennsylvania upheld a $3 million dollar verdict awarded to Katherine Palar to compensate for a four year delay in cancer diagnosis which reduced her chances of survival from approximately 70 percent to less than 25 percent. Palar's struggle began in March of 2009 when she received an MRI after complaining of back pain. The radiologist who reviewed the MRI was obligated by the standard of care to observe all aspects of the images at hand but failed to notice an irregularity in the right lung of the victim. This initial oversight ultimately led to a significant delay in diagnosis which likely cost Palar her life. After the trial, the defendants filed an appeal based on the denial of their request to admit Palar's smoking history as evidence and the claim that medical evidence presented late in the trial was hearsay. The three judge panel dismissed the defendants' request for a retrial, upholding the largest verdict of this type in Jefferson County, PA.
Stage IA to Stage IIIA Cancer in Four Years
Over the course of the four year delay in her diagnosis, Palar's cancer progressed from what would have initially been classified as a stage IA non-small cell carcinoma to a stage IIIA mass which measured 4.8 x 2.5 cm in size. At that point, the cancer had already metastasized into Palar's lymph nodes. Had the cancer been detected in 2009, Palar would have had a 73 percent chance of surviving another five years and would have been a candidate for surgical removal of the mass without subsequent chemotherapy treatments. Instead of this simplified treatment protocol, Palar was subjected to 33 radiation treatments and multiple rounds of chemotherapy. She was also no longer a candidate for surgical removal of the mass, as it had already metastasized. Palar was reported to have suffered from internal damage and burns on her back from the intense cancer treatments, and was said to have lost 50 pounds during her treatment regime. Ultimately, Palar's cancer spread to her brain and led to her death shortly after the conclusion of the initial trial.
A Breach in the Standard of Care
During a medical malpractice trial, experts are called to testify as to whether an attending physician or health care provider failed to provide a minimum standard level of care to the patient. In Palar's case, two doctors were deemed negligent due to their failure to notice the growing mass within Palar's right lung. Initially, Dr. John Wohlwend reviewed a series of two MRI's taken in March and April of 2009. Although the MRI's were focused on Palar's thoracic spine area, the lungs were in view. Radiologists are obligated to review an entire image, including areas beyond the zone of primary focus according to the standard of care. If any questionable sections exist, the medical care provider must recommend further review or testing. An expert verified that the initial MRI showed signs of abnormalities in Palar's right lung, yet Dr. Wohlwend failed to notice this condition. In 2010 and 2012, Palar complained of a persistent cough and was given chest x-rays to search for abnormalities. In these instances, Dr. Kamal Khalaf reviewed the x-rays and did not discover any abnormalities in the lungs, despite the fact that Palar's mass had increased in size.
Palar's History of Smoking Not Permitted as Evidence
Palar had a 40 year history of smoking but Judge John H. Foradora of the Jefferson County Court of Common Pleas did not permit this evidence to be admitted on the basis that the jury could become unduly prejudiced against Palar. Although the defense argued that lack of awareness of Palar's habit was a significant factor that impacted the doctors' level of scrutiny when examining the images of Palar's lungs, the judge disagreed and maintained the perspective that the health care providers were still obligated to maintain the same standard of care regardless of the patient's medical history. The appeals judge upheld this decision and denied a new trial on this basis.
Testimony Related to a Decline in Health Admitted
Near the end of her trial, Palar's physician testified that her cancer had reached the brain and was certain to cause her demise in short order. The defense argued that such testimony was hearsay and likely to sway the jurors in favor of Palar, yet the judge overruled this objection and the appeals judge withheld the original position.
The Largest Verdict in the History of Jefferson County
Ultimately, Palar was awarded $1.5 million in past economic losses and another $1.5 million in future noneconomic losses, leading to the largest verdict ever awarded for a medical malpractice case in Jefferson County, PA. Although Palar passed away before the appeals court could uphold the initial verdict, family members named in her estate will receive the compensation.
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