Getting a look inside a medical practice computer system—not just a copy of the file—was the key to settling a medical malpractice case for the widow of a 24-year-old man who died from cancer that his doctors missed, her attorney said.

Lloyd Bell of the Bell Law Firm in Atlanta said Friday he has settled a wrongful death case against Kaiser Permanente for a confidential sum. The settlement concludes the lawsuit brought by the widow of Ryan Stephens, who died in 2016 from testicular cancer that went undiagnosed by two doctors at Kaiser, according to Bell and the complaint.

Stephens went to his primary care doctor, Dr. Audra Ford at Kaiser Permanente West Cobb Medical Center, reporting a mass on his left testicle. Dr. Ford did not perform a physical exam or order an ultrasound to investigate possible testicular cancer, the suit claimed. She referred him instead to Kaiser urologist Dr. Barry Mason for further evaluation, Bell said.

At the follow-up appointment, Mason examined Stephens, but testified he did not feel an unusual mass as initially reported, and did not order an ultrasound. Instead, the urologist sent Stephens home with directions to "self-examine" for possible cancerous masses, the suit claimed.

Stephens returned to Kaiser several months later reporting pain in his abdomen. Ford thought Stephens had "muscle strain," and gave him a prescription and sent him home. Stephens returned two months later, this time reporting lower back pain. Ford again examined Stephens and sent him home with a prescription for muscle relaxers, Bell said.

Three months later, Stephens' wife Courtney Stephens called 911. She told the 911 operator that her husband was in extreme pain and couldn't walk. The emergency responders rushed Stephens to a nearby hospital, where he was immediately diagnosed with metastatic testicular cancer—cancer that had spread throughout his body, including his liver. He died just a few weeks later.

Bell said the case settled soon after he requested a forensic inspection of the medical practice computer system.

"We told defense counsel we wanted to look at our client's medical records in the native electronic system," Bell said. "When you print out the chart or create a searchable PDF, that doesn't tell you how this information is stored and what it looks like in the computer. It's very important for us to learn when an order is put in that causes the computer system to react a certain way."

What the plaintiffs counsel learned from the forensic discovery is that Kaiser Permanente's internal guidelines called for an ultrasound when a patient reports feeling such a mass, Bell said.

Jeff Tompkins of Thomas Kennedy Sampson & Tompkins in Atlanta represented Kaiser Permanente. Tompkins could not be reached immediately.

Bell said Tompkins was "just the picture of professionalism"—"a classical gentleman, ethical, professional and above board."

The case is over but still on Bell's mind.

"He was a perfectly healthy kid," Bell said. "I've got teenage boys now, and it's close to home. This kind of cancer is incredibly treatable, with a 95% cure rate—even after it spreads. It's very sensitive to radiation and chemotherapy."

Testicular cancer is rare but known to affect young men—who might not be the most diligent about checkups, and who need to know to follow up and ask for imaging tests, Bell said.

Bell said he normally doesn't like to talk about confidential settlements. But, he added, "this one seemed important."