Pathology Errors.

A pathology report is a routine and important part of almost every surgery in which some tissue is removed from the body.  The tissue removed is sent to the pathology department of the hospital or to an independent pathology group, if the surgery is not performed at a hospital.  The tissue is prepared for examination which may involve a number of steps including staining to bring out certain features.  The tissue is then sliced thinly and placed on a slide for microscopic viewing by a pathologist.  The pathologist is a specially trained physician who examines the tissue to determine if it is abnormal or not.  The pathologist makes a report to the surgeon, who then makes treatment decisions based on the nature of the tissue as reported by the pathologist.

Not all pathologists reach the same conclusions, even when looking at the same tissue slides.  Disagreements about interpretations are common and are of concern, especially when the questions are whether the tissue is cancerous or not, its aggressiveness and the extent to which it has spread.  Life and death decisions are being made on the basis of the interpretation by by the pathologist.  A study published in the March 17 issue of the Journal of the American Medical Association (JAMA) found that as many as one in four breast biopsies are initially misdiagnosed.  In the JAMA study 115 pathologists reviewed 60 test slides of breast biopsies.  They only agreed 75% of the time about the proper interpretation.  Fortunately, the highest level of agreement was on slides showing invasive carcinoma (96%).  In cases of atypia, unusual but not cancerous cells, the rate of agreement was only 48%.  Some of the disagreements involved cases in which the pathologists thought the slide showed something more serious than it did while in others the pathologists thought the slide showed something less serious than it actually did.

We have represented a number of clients over the years in which there was a serious error made in the interpretation of a pathology slide.  Two of the cases involved melanomas which were misread by the pathologist.  In both of those cases the error lead to the death of the patient.

While pathologists do the best they can, the process itself depends on interpretation, the quality of the slide prepared from the tissue and the skill of the pathologist.  Mistakes are made and can lead to death or serious injury.  If time permits, before making a serious decision based on the interpretation of a pathology slide, consider asking for a second opinion.  It can’t hurt and it may make a difference in your care.

Posted in Doctors, medical errors, medical mistakes, Medical Negligence, Melanoma |