A Lutherville woman whose breast lump developed into incurable cancer has been awarded $1.44 million by a state arbitration panel that found her doctor failed to review key medical records and order conclusive diagnostic tests over a period of 20 months.
"My father will be 90 years old this April, and my mother is 89," said Irene B. Greeley, 48. "I had a good chance of attaining those years. Having cancer is like having a time bomb in your body. You just never know. I've learned to live with it, but you just never know."
Mrs. Greeley, who first sought treatment in June 1988 for a lump she found in her right breast, was not diagnosed with cancer until February 1990. The survival rate for women whose breast cancers are detected early is about 90 percent, medical authorities say, but that rate drops sharply as treatment is delayed.
In the past two years, Mrs. Greeley, assistant manager of a Towson department store, has undergone six months of chemotherapy and one operation. She faces costly bone marrow transplant surgery.
Physicians tell her the cancer has spread and multiplied in other parts of her body, and her chances of surviving are not good.
Now Mrs. Greeley wonders what will happen to her family: husband, John, an accountant; two grown sons; a daughter in college and a daughter in high school. "It's kind of scary," she said. "It really is."
In its decision this week, the Maryland Health Claims Arbitration Office ordered Dr. Ian Slepian and CareFirst Inc., a health maintenance organization to which Mrs. Greeley belonged, to pay the $1.44 million in damages. The figure includes $750,000 for "pain and suffering and mental and emotional harm."
The panel said Dr. Slepian, of the Galleria Health Center in Lutherville, failed to review Mrs. Greeley's medical records and a written report on her mammogram shortly after she made two visits to the center in June 1988.
"Obviously we're disappointed with the decision," said David Bamberger, the lawyer representing Dr. Slepian. "We think it's wrong, and we'll be appealing it."
He declined to discuss the case further.
Mrs. Greeley's medical records included a 1986 mammogram "recommending careful physical examination," the panel said. The June 1988 mammogram report included a note by a radiologist saying he lacked earlier X-rays for comparison.
At that time, the panel found, the physician should have ordered a surgical biopsy of Mrs. Greeley's suspicious lump.
During those 1988 visits, said Gary Strausberg, a Baltimore malpractice lawyer representing Mrs. Greeley, she did not see Dr. Slepian but a physician's assistant he supervised. The assistant told Mrs. Greeley that "everything is fine and you have nothing to worry about," the lawyer said.
When Mrs. Greeley saw Dr. Slepian in June 1989 about a suspicious but benign lump on her forehead, she did not mention her breast lump, the arbitration panel said. It said the physician's assistant, described as "overbearing and intimidating," assured Mrs. Greeley that only changes in her breast lump needed to be reported.
The panel also found that, during the June 1989 visit, Dr. Slepian "made no inquiry about other lumps or apparently even looked at the note" detailing his patient's visit the previous year.
The cancer was finally discovered after Mrs. Greeley complained in February 1990 that her breast lump had grown. "They were shocked, I think," Mrs. Greeley said.
She said she was pleased by the award in part because "I kind of pursued this in the hopes that someone will be a little more careful the next time."