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$1.6 million settlement for failure to diagnose hereditary cancer

Approximately 5-10% of all cancers are hereditary. For several decades, a constellation of factors known as the “Hallmarks of Hereditary Cancer” have been repeatedly described throughout the medical literature in hundreds of articles and textbooks. The following are uniformly considered to be “Hallmarks of Hereditary Cancer”:

  1. Early age of onset of cancer, usually 10 to 15 years earlier than sporadic cancers occurring in the general population.
  2. Bilaterality (cancer occurring in paired organs such as the breast or ovaries).
  3. Multiple primaries occurring in the same individual (two or more different types of cancers).
  4. Multiple family members with cancer.
  5. Multiple generations of cancer in a family (vertical transmission).

Despite the Hallmarks’ prevalence in the literature, too many primary care doctors continue to fail to obtain careful, detailed histories from their patients. A careful history with attention to detecting family cancer pedigrees will reveal patients at high risk for certain hereditary cancers like colon, ovarian, and breast cancer. Persons with such pedigrees should be carefully monitored and possibly offered prophylactic surgical procedures.

One of our clients whose doctors failed to identify hereditary cancer was 43 years old when she died in 1999 from ovarian cancer, leaving her husband and 10-year old daughter. To our knowledge, this was the first medical malpractice case to ever argue that a physician was negligent for failing to anticipate hereditary cancer and remove the likely future site of the cancer.

By 1993, our client had every one of the five Hallmarks, including two separate primary breast cancers, diagnosed when she was 28 and 37. Her health care providers regularly documented her personal and family history; but all failed to recognize the significance of what they were charting. With such a history, prophylactic removal of the ovaries should have been recommended, which would have eliminated our client’s very high risk of developing ovarian cancer. Our advocacy in this case and others has helped spread the word on hereditary cancer and has caused physicians to alter their practices.

Seattle Times article about this case