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Medical blunder

When she heard the diagnosis of invasive lobular

carcinoma, Darrie Eason had but one thought: Please don't let me die.

Four months and a double mastectomy later, doctors told Eason that her

tissue sample had been mislabeled, and that she never had cancer.

"I didn't know what to believe," said Eason, a 35-year-old single mother

from Long Beach. "They told me I had cancer and now they're telling me I

didn't. I didn't know if the next day they were going to call me and say,

'Sorry, we made a mistake, you really do have cancer.'"

According to her attorney and a New York State health department report,

Eason is the victim of a mix-up at the CBLPath medical lab in Rye Brook, N.Y.

Eason filed a lawsuit against CBLPath in State Supreme Court in Mineola last

month seeking an undisclosed sum of money.

The 1 1/2-page state report, issued last August to CBLPath, refers to a

company report that blamed the mix-up on a technician who admitted cutting

corners while labeling tissue specimens.

CBLPath chief executive William Curtis said he was familiar with Eason's

case but could not speak about any of his company's patients because of federal

privacy laws. He said the CBLPath doctor who signed off on Eason's diagnosis,

Dr. Beiyun Chen, no longer works for the company but said her departure "has

nothing to do with this case." Chen could not be reached for comment.

The technician responsible for the mix-up, Curtis said, also is no longer

with the company. He declined to say whether the technician's departure was

related to this case.

While the state report found "no systemic problems" at CBLPath, her

attorney, Steven E. Pegalis, of Lake Success, said the lab must be held

accountable for its error.

"You kind of assume that if a lab diagnoses you as having cancer, you've

got it," he said. "How do you have faith and trust in systems that are supposed

to be infallible?"

Pegalis said they chose not to sue Eason's doctors because they were

working with flawed information provided to them by CBLPath.

Medical experts say mistakes of this magnitude are extraordinarily rare.

Jim Conway, a senior fellow at the Institute for Health Care Improvement, a

not-for-profit health research organization in Cambridge, Mass., said labs must

create systems that prevent human errors from going unchecked.

"We have to put in place systems that mitigate chances of a human being

making a mistake," he said.

Claire Pospisil, a spokeswoman for the state health department, said

mistakes like Eason's are "very rare" in New York. She said the state's

investigation ended with its report.

The case is not the only one of its type on Long Island.

In 2005, Lynne Yurosko of Garden City underwent a lumpectomy and 25

radiation treatments before being told she never had cancer. Last year,

Yurosko, now 57, sued the Quest Diagnostics lab, the Nassau Radiologic Group

and four doctors. Her case is set to go to trial next year, said her attorney,

Bob Sullivan of Garden City [CORRECTION: Lynne Yurosko of Garden City, who

underwent a lumpectomy and had radiation treatments for cancer she did not

have, dropped her lawsuit against Nassau Radiologic Group in December. A story

Wednesday cited the lawsuit, which still is outstanding against Quest

Diagnostic medical lab. A17 ALL 10/5/07].

Eason, who works in the accounts receivable division of a community

newspaper chain, said she is in constant physical and emotional pain from the

surgery. She has less strength and flexibility in her upper body and is no

longer able to perform tasks like opening her office window. She said she hopes

that by bringing her case to court, she can help to fix the system.

"I'd like for no woman of any age to have to deal with the pain and the

emotions that mistakes can cause," she said. "And I'd like somehow to change

this - mistakes like this can't happen."

STEPS AND SAFEGUARDS

How often is breast cancer misdiagnosed?

In a report last year, Susan G. Komen for the Cure estimated between 5,000

and 10,000 breast cancer diagnoses annually may be wrong. The organization,

which funds numerous major breast cancer studies, estimates as many as 90,000

women who are living with breast cancer in the United States may have

inaccurate diagnoses.

Are patients often diagnosed as having cancer and then scheduled for

surgery?

While misdiagnoses do occur, situations involving a misdiagnosis of cancer

and subsequent double mastectomy are virtually unheard of, said Dr. Dwight

Randle, Komen's senior scientific adviser. Randle said widespread use of

electronic record-keeping has helped eliminate clerical errors involved in

misdiagnoses. Nonetheless, Komen officials are pressing for the unification of

pathology standards to ensure that laboratory procedures, which underlie each

patient's regimen of care, are the same at medical and cancer centers

nationwide.

What safeguards are in place to ensure that patients receive the correct

diagnosis and surgery?

A team of multiple specialists consult with each other and examine

mammograms and laboratory findings and then recommend a treatment plan. Checks

and balances, Randle said, are built into the multidisciplinary approach,

helping to prevent devastating mistakes.

Are team-oriented programs available on Long Island?

Yes. All major cancer centers and breast-care centers in Suffolk and Nassau

offer team-oriented care.

What safeguards are in place to prevent a patient from receiving the wrong

surgery?

Many medical centers are adopting what Randle calls the Florida Plan.

Before anesthesia is administered, the patient verbally states the reason for

the surgery. Each health care provider in the surgical suite also verbally

states the reason for the surgery to ensure that everyone is in agreement and

aware of why the procedure is being performed.

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