Levin & Perconti attorneys John Perconti, Mike Bonamarte, and Daniel Goldfaden secured an $8.125 million verdict on behalf of the estate of Althea Wright, a 62-year-old woman who died from lung cancer that a radiologist failed to detect after spending approximately 80 seconds reviewing her chest x-ray.
The radiologist later admitted that fatigue was the most likely reason she missed the abnormality.
What Happened
On August 9, 2013, Althea Wright went to the emergency room at MetroSouth Medical Center in Blue Island, Illinois, with fatigue, shortness of breath, anemia, and a rapid heartbeat. The ER physician ordered a chest x-ray among other tests. The radiologist on duty reviewed the film and found no abnormality. She did not recommend follow-up or repeat imaging. Ms. Wright was admitted for several days, diagnosed with a gastrointestinal bleed, and discharged.
More than a year later, in October 2014, Ms. Wright returned to the emergency room, experiencing dizziness and lightheadedness. A second chest x-ray was taken, and this time the radiologist identified a possible abnormality. The subsequent CT scan revealed a mass in the same area of the lung where an abnormality had been present on the 2013 x-ray. Further testing and a biopsy confirmed a diagnosis of Stage III squamous cell lung cancer. The tumor had spread to the lymph nodes. It was inoperable.
Ms. Wright underwent four months of chemotherapy and radiation, up until she passed away on March 2, 2015, at the age of 64. She is survived by two adult children.
Levin & Perconti filed a lawsuit on Ms. Wright’s behalf, alleging she should have been diagnosed with lung cancer when she was first x-rayed in 2013. Our medical malpractice attorneys established that when this first x-ray was taken, the cancer was still Stage I and had not spread to the lymph nodes. At that point, a lobectomy could have cured it. Instead, a 14-month delay allowed the cancer to progress from treatable to terminal.
The 80-Second Review of her X-Ray
The defendant radiologist reviewed Ms. Wright’s x-ray at approximately 4:30 in the afternoon, after working from 7:00 that morning. She had already reviewed 80 to 90 other images that day. Records showed the x-ray file was open on her screen for 80 seconds. Of that time, evidence indicated she spent approximately 20 seconds actually evaluating the film. This failure to examine the x-ray thoroughly cost Ms. Wright her chance at survival.
This radiologist retired from practice in 2014 and passed away several months before trial. Her 2019 video discovery deposition was played for the jury. In it, she acknowledged that fatigue was the most likely explanation for why she failed to identify the abnormality.
The 3-centimeter mass was located behind the heart, in an area that the defense argued was subtle and easily obscured. The defense also contended that physicians reviewing the 2013 x-ray, after the diagnosis was known, were subject to hindsight bias; that the abnormality was only visible in retrospect. Levin & Perconti’s radiology expert testified otherwise. The chest x-ray was shown to the jury, and the mass was clearly visible to even a layperson, leaving fatigue as the only credible explanation for why it was missed.
We depend on doctors to take advantage of opportunities to diagnose and treat patients properly and in a timely manner. We trust them to live up to that responsibility and perform their duties of care. When that trust is broken, they must be held accountable.
Physician Fatigue as a Standard of Care Issue
This case raised a question that goes beyond one radiologist and one x-ray: what obligations do physicians have to manage fatigue in ways that protect their patients?
The standard of care requires physicians to recognize the limits that fatigue places on clinical judgment; and to act accordingly. Levin & Perconti attorneys argued that the radiologist was not only negligent in her failure to identify the mass and recommend a follow up, but that she was negligent in her failure to take breaks and other protective measures to counteract working a long shift while reviewing a high volume of images.
Physicians have a professional responsibility to recognize when fatigue may impair their judgment and to take reasonable steps to reduce that risk. Patient safety depends not only on medical knowledge and technical skill, but also on a physician’s ability to ensure that fatigue does not compromise the care they provide.
The Verdict
The jury returned a verdict of $8.125 million on behalf of Ms. Wright. No verdict can undo the pain she endured, nor what her family lost, but this result gives them the means to move forward and the recognition that what happened to Althea Wright should not have happened at all.
The trial was covered by the Chicago Daily Law Bulletin in January 2020.
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