The urologist suspected prostate cancer for a long time, but did not pursue it with the necessary rigor for unexplained reasons and did not initiate any further examinations.
Lawyer Marc Melzer from Bad Lippspringe, specialist lawyer for medical, social and insurance law: “In 2012 my client’s family doctor found an increased PSA value of 6.7 and therefore sent the man to a urologist.” The PSA value, a Enzyme level, is determined from the blood and can indicate changes in the prostate. It is not a clear tumor marker. An increased value can also result from inflammation or from mechanical stress on the prostate, for example when cycling. However, a value that rises over time should prompt the doctor to carry out further tests.
The urologist found an enlarged prostate and named the PSA value according to age. However, he noted his suspicion of prostate cancer in the patient file. He called the patient for five follow-up appointments and determined PSA values that rose to 8.2 within a year. The urologist thought a biopsy of the prostate was necessary and noted this in the patient’s file, but said nothing to his patentee.
Lawyer Marc Melzer: “Three years later, the urologist again took blood from the patient and determined a PSA value of 9.2. This time he wrote in the file that a biopsy of the prostate was necessary, but said nothing about it. ”In 2017 the patient finally went to another urologist. The diagnosed cancer and had the prostate removed in a Paderborn hospital. Marc Melzer: “The patient then had his original urologist give him the documents and discovered the clues about necessary biopsies that he hadn’t known about.”
Melzer filed a lawsuit against the doctor on behalf of his client. The expert commissioned by the Paderborn Regional Court came to the conclusion that there was a “gross diagnostic error” if one did not talk about a biopsy at six treatment appointments in one year. Melzer: “Why the urologist failed to address this examination could not be clarified in the process. He said he couldn’t reach my client, but of course that wasn’t conclusive. ”
It is unclear whether earlier treatment would have made a gentler therapy possible, but neither did it have to be discussed. Because in the case of gross medical malpractice, the burden of proof that the medical malpractice did not have the claimed effects lies with the doctor, and this proof could not be presented.
Prostate cancer is the most common cancer in men. In 2016, according to the German Cancer Research Center, it was newly discovered in almost 60,000 men. At the time of diagnosis, those affected were an average of 72 years old. Around 14,000 men die from it every year. Those with statutory health insurance are entitled to an annual medical check-up from their 45th birthday. It includes a medical history (also with a view to possible family history) and a rectal palpation examination. The PSA determination is only taken over by the health insurance company if cancer is suspected. It costs around 25 to 35 euros.
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