Victim of error, patient treats non-existent metastasis – 01/11/2024 – Health

The court ordered Amico Saúde to pay R$200,000 for moral damages and R$17,900 for material damages to a patient who for six years underwent treatment for a bone metastasis that, in reality, never existed.

According to the process, in addition to the emotional impact, the unnecessary treatment caused loss of bone mass and mobility. It also damaged the patient’s dentition, leading to the need for bone grafting and the use of prostheses.

“Once the diagnostic error was made, the patient was led to suffering that could have been avoided or alleviated, imposing the duty of reparation for moral and material damages”, wrote judge Edson Luiz de Queiroz in the ruling.

The report tried to contact the patient’s and Amico’s lawyers, but has not yet received a response.

The 9th Chamber of Private Law of the São Paulo Court of Justice analyzed the appeal filed by Amico in December, but the case dates back to June 2010. It was in that month that the patient, then 54 years old, discovered a lump in her right breast.

The tumor was malignant and, in October of the same year, she underwent a mastectomy. After surgery, she began treatment with chemotherapy, immunotherapy with trastuzumab and hormone therapy with anastrozole. This protocol lasted until 2012, when it was modified in light of the supposed bone metastasis.

According to the records, no exam showed bone metastasis — the material collected during surgery indicated lymph node metastasis. Even so, in 2011, the doctor treating the patient changed the treatment.

“Now, there was a statement of diagnosis of bone metastasis at some point, without foundation, and in a way divorced from the evidence and exams, including contrary to the scintigraphy exam, which ruled out signs of bone metastasis”, wrote judge Patricia Svartman Poyares Ribeiro in the 1st degree decision.

“The bone metastasis was noted at a certain point in the medical record and remained that way for years, due to inertia and error on the part of the doctors who treated the author. It is not known whether this was due to pure negligence or as a measure to save money on carrying out new exams. There was, therefore, error in analysis and treatment recommendation by the author’s doctor”, he added.

The oncologist changed the treatment to fulvestrant associated with trastuzumab and zoledronic acid, and the patient continued with the new regimen until doctors from her new health plan discovered the error. Two PET Scans, in 2017 and 2018, showed that there was never any bone metastasis. The examination carried out by the patient as part of the legal action also did not find any evidence of the disease.

Amico was convicted in the first instance, but appealed claiming that it could not be penalized for errors by accredited doctors and that the professionals were responsible. The judges, however, disagreed with this view.

“The health plan and the hospital are also responsible for the failure to monitor the conduct carried out by their agents and partners”, decided Queiroz, whose opinion was followed by the other judges.

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