It has long been understood that the issue of whether a departure from proper medical care was a cause of harm is often a difficult question in medical malpractice actions. See Toth v. Community Hosp. at Glen Cove, 22 N.Y.2d 255, 261 (1968). Cases stemming from claims of delay in diagnosing cancer may epitomize that difficulty. Early detection is frequently the greatest weapon in fighting that potentially deadly disease, and the negligent failure to diagnose the cancer can cost a patient his or her life. The determination of whether diagnosis at or near the time of the malpractice would have saved the patient’s life can be dependent upon many factors, including the type of cancer, the stage at which it should have been caught, the aggressiveness of the particular cancer and the available modes of treatment. Each of these factors must be addressed by expert testimony in relation to the specific facts and circumstances of the case.
Causation in failure to diagnose cancer cases often involves probabilities; therefore, liability is not dependent upon proof that the patient would have been cured and their life saved by timely diagnosis. Instead, liability may be established by showing a diminution of the chances of cure or, alternatively, by proof that the patient’s life could have been prolonged with an earlier diagnosis. An additional and separate issue is whether the delay resulted in pain and suffering, beyond what the patient would have experienced with timely diagnosis. This is often the case where the delay necessitates more painful or disfiguring treatment, such as more extensive surgery or the need for chemotherapy or radiation.
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