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PUBLIC SERVICE ANNOUNCEMENTS
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What Doctors Are Saying
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When the Standard of Care Is Deficient
- Don’t Let This Happen to Others
by Chris Wright (retired attorney)
October 2023
The news I had a cancerous tumor came as a shock. It was discovered during a colonoscopy in March 2023. The diagnosis: Stage 3 colon cancer. The tumor was removed in May and I started chemo in June. The first four rounds were uneventful but, after the fifth, I saw stars, felt dizzy, and fell down five minutes into a walk to get to round six. I managed to make it to the medical building where the chemo nurse took one look at me and sent me to the emergency room.
I was evaluated and told I had a field of blood clots in my lungs, including two sizeable ones blocking key arteries to the heart (pulmonary embolism). I had an operation the next day to suction out enough of the two largest clots to restore blood flow to the heart. I was put on blood thinner, the doctors expecting this to allow my body to work on clearing the clots from my lungs and to prevent the formation of new clots.
This all took place in a large hospital system with a good reputation in a major eastern city - hardly a medical backwater.
Every medical professional I encountered in the hospital told me chemo causes blood clots. However, blood clots are not on the list of side effects of the chemo drugs I was given. Moreover, my oncologist told me the hospital professionals were wrong, fallaciously assuming causation from seeing so many chemo patients with blood clots (post hoc, ergo propter hoc). The oncologist said causation is much murkier, but chemo is not the culprit.
So, not all agree chemo causes blood clots, but all do agree a cancer diagnosis puts patients at higher risk of blood clots.
However, I wasn’t warned about blood clots when I received my cancer diagnosis. I wasn’t thoroughly evaluated. My coagulation factors were not monitored. And I wasn’t put on blood thinner prophylactically, as I believe patients at high risk should be.
Therefore, I believe the applicable standard of care is deficient. My surgeon and my oncologist followed the cookbook, but there’s something wrong with the cookbook. It’s missing a few ingredients. In light of the potentially dire consequences, blood clot evaluation and monitoring should be part of the standard of care the minute a cancer diagnosis is received. My surgeon should have set this in motion, way back in March when all this started. My oncologist should also have been on top of this. But they weren’t, because IT WASN’T IN THE COOKBOOK.
My oncologist did look at one blood test metric for clotting, but didn’t pursue the subject when the metric showed me to be in the normal range. This showed consciousness of the issue, but one metric obviously wasn’t enough. Look at what happened to me. I almost died. Res ipsa loquitur - the thing speaks for itself.
In law school, we studied the T.J. Hooper case. At issue was a certain feature not standard on marine radios. The manufacturer argued it should not be held liable because there was no industry standard requiring the feature be installed in all radios. The court went the other way, concluding the entire industry was negligent for not equipping all radios with the feature that would have prevented the tragedy in the case.
And so it is I believe the entire medical profession’s performance in cases like mine is unsatisfactory because the applicable standard of care is deficient.
I urge the medical profession to revise the standard of care to keep what happened to me from happening to other people. It was completely foreseeable. It could have been catastrophic. I could have died. (There was an emergency case on the table right before me.) What happened to me will happen to others, unless something changes. The standard of care is deficient and it’s time to fix it - both so what happened to me doesn’t happen to others and so medical professionals can avoid legal liability from claims filed by patients more litigious than me. If you’re in cancer care, you’ve been warned.
Medical Authorities Notified
My Cancer Care Providers
Medical Oncology Board (ABIM)
American Society of Clinical Oncology
European Society for Medical Oncology
American Society of Colon and Rectal Surgeons (ASCRS)
American Board of Colon and Rectal Surgery
National Cancer Institute
American Cancer Society
Mayo Clinic
Cleveland Clinic
MD Anderson Cancer Center
Memorial Sloan Kettering Cancer Center
Dana-Farber Cancer Institute
- Don’t Let This Happen to Others
by Chris Wright (retired attorney)
October 2023
The news I had a cancerous tumor came as a shock. It was discovered during a colonoscopy in March 2023. The diagnosis: Stage 3 colon cancer. The tumor was removed in May and I started chemo in June. The first four rounds were uneventful but, after the fifth, I saw stars, felt dizzy, and fell down five minutes into a walk to get to round six. I managed to make it to the medical building where the chemo nurse took one look at me and sent me to the emergency room.
I was evaluated and told I had a field of blood clots in my lungs, including two sizeable ones blocking key arteries to the heart (pulmonary embolism). I had an operation the next day to suction out enough of the two largest clots to restore blood flow to the heart. I was put on blood thinner, the doctors expecting this to allow my body to work on clearing the clots from my lungs and to prevent the formation of new clots.
This all took place in a large hospital system with a good reputation in a major eastern city - hardly a medical backwater.
Every medical professional I encountered in the hospital told me chemo causes blood clots. However, blood clots are not on the list of side effects of the chemo drugs I was given. Moreover, my oncologist told me the hospital professionals were wrong, fallaciously assuming causation from seeing so many chemo patients with blood clots (post hoc, ergo propter hoc). The oncologist said causation is much murkier, but chemo is not the culprit.
So, not all agree chemo causes blood clots, but all do agree a cancer diagnosis puts patients at higher risk of blood clots.
However, I wasn’t warned about blood clots when I received my cancer diagnosis. I wasn’t thoroughly evaluated. My coagulation factors were not monitored. And I wasn’t put on blood thinner prophylactically, as I believe patients at high risk should be.
Therefore, I believe the applicable standard of care is deficient. My surgeon and my oncologist followed the cookbook, but there’s something wrong with the cookbook. It’s missing a few ingredients. In light of the potentially dire consequences, blood clot evaluation and monitoring should be part of the standard of care the minute a cancer diagnosis is received. My surgeon should have set this in motion, way back in March when all this started. My oncologist should also have been on top of this. But they weren’t, because IT WASN’T IN THE COOKBOOK.
My oncologist did look at one blood test metric for clotting, but didn’t pursue the subject when the metric showed me to be in the normal range. This showed consciousness of the issue, but one metric obviously wasn’t enough. Look at what happened to me. I almost died. Res ipsa loquitur - the thing speaks for itself.
In law school, we studied the T.J. Hooper case. At issue was a certain feature not standard on marine radios. The manufacturer argued it should not be held liable because there was no industry standard requiring the feature be installed in all radios. The court went the other way, concluding the entire industry was negligent for not equipping all radios with the feature that would have prevented the tragedy in the case.
And so it is I believe the entire medical profession’s performance in cases like mine is unsatisfactory because the applicable standard of care is deficient.
I urge the medical profession to revise the standard of care to keep what happened to me from happening to other people. It was completely foreseeable. It could have been catastrophic. I could have died. (There was an emergency case on the table right before me.) What happened to me will happen to others, unless something changes. The standard of care is deficient and it’s time to fix it - both so what happened to me doesn’t happen to others and so medical professionals can avoid legal liability from claims filed by patients more litigious than me. If you’re in cancer care, you’ve been warned.
Medical Authorities Notified
My Cancer Care Providers
Medical Oncology Board (ABIM)
American Society of Clinical Oncology
European Society for Medical Oncology
American Society of Colon and Rectal Surgeons (ASCRS)
American Board of Colon and Rectal Surgery
National Cancer Institute
American Cancer Society
Mayo Clinic
Cleveland Clinic
MD Anderson Cancer Center
Memorial Sloan Kettering Cancer Center
Dana-Farber Cancer Institute