Failure to Follow Up on a Lung Nodule FAQs

A lung nodule is a small area of abnormal tissue that appears on an imaging study. Nodules can develop for many reasons, including prior infections, inflammation, scarring, and cancer. A nodule alone does not establish that a patient has lung cancer. A provider must evaluate the finding in context. Relevant considerations may include the nodule’s size, shape, borders, density, location, and growth rate, as well as the patient’s age, smoking history, prior cancer history, occupational exposures, and other risk factors. Depending on those circumstances, a provider may recommend comparison with earlier images, a repeat CT scan after an appropriate interval, a PET scan, referral to a pulmonologist or thoracic specialist, or a biopsy. Some low-risk nodules may not require continued surveillance. The central issue is whether the provider recognized the finding and responded in a manner consistent with accepted medical practice.

Lung cancer may be more treatable when it is confined to a limited area, while cancer that has spread can require more extensive treatment and may carry a less favorable prognosis. If a suspicious nodule is not monitored, the cancer may grow, involve nearby lymph nodes, invade surrounding structures, or metastasize to distant organs. A patient who could have undergone a limited surgical procedure may later require removal of a larger portion of the lung, chemotherapy, radiation therapy, immunotherapy, targeted treatment, or a combination of therapies. More extensive treatment can produce additional pain, fatigue, breathing limitations, complications, emotional distress, medical expenses, and lost income. The harm caused by a delay depends on the cancer’s type and biology, the duration of the missed follow-up, the patient’s overall health, and the treatment that likely would have been available earlier. Medical experts usually assess these issues by reviewing serial images, pathology findings, staging information, and the patient’s treatment history.

A patient alleging malpractice generally must prove that a healthcare provider owed a professional duty, departed from accepted medical practice, and caused compensable harm. In a lung nodule case, the alleged departure may involve failing to communicate the finding, recommend appropriate surveillance, order a repeat scan, refer the patient to a specialist, or act after evidence of growth appeared. The patient must also establish causation. Showing that a mistake occurred is not enough. The evidence must support the conclusion that the failure was a proximate cause of additional injury, such as progression to a more advanced stage, loss of a less invasive treatment option, or a diminished prognosis. These cases usually require testimony from qualified medical experts who can explain the applicable standard of care, identify any departure, and address how timely follow-up probably would have affected the patient’s diagnosis and treatment.

Compensation is intended to address the additional losses caused by a negligent delay. Recoverable economic damages may include expenses for diagnostic testing, hospitalization, surgery, medication, rehabilitation, home assistance, future treatment, lost wages, and diminished earning capacity. Non-economic damages may compensate for physical pain, emotional suffering, impaired breathing, physical limitations, loss of enjoyment of life, and the burdens associated with more aggressive treatment. If delayed diagnosis leads to death, the patient’s estate and qualifying family members may be able to pursue survival and wrongful death claims.

New York medical malpractice actions generally must be commenced within two years and six months of the negligent act or omission or, in qualifying circumstances, the end of continuous treatment for the same condition. A special discovery provision applies to certain claims alleging a negligent failure to diagnose cancer or a malignant tumor. It may allow the limitations period to run from when the patient knew or reasonably should have known about the negligent act or omission and the resulting injury, subject to an outside limit. Claims involving public hospitals or government-affiliated providers may be governed by shorter deadlines and notice requirements. Calculating the deadline can be particularly complicated when several providers missed the same nodule over time.