http://abcnews.go.com/sections/GMA/Living/GMA030811Medical_errors.html
Cancer patient's penis removed in one of many high-profile medical mistakes.
Hurshell Ralls discovered that his penis and testicles had been removed during
surgery. (ABCNEWS.com) ‘Total Disbelief’
Penis Removal Just Latest In Series of Surgical Mistakes, But Patients Can
Protect Themselves
Aug. 11— After 67-year-old Hurshell Ralls went into surgery for bladder
cancer, he came out of surgery missing more than he ever expected. His penis
and testicles were gone.
"My wife had to hold my hand in the bed there. And she said 'Honey it's over.
They got all the cancer.' And she waited a few minutes and then said 'But they
had to remove your penis.' And I was one mad dude, you know," Ralls said on
ABCNEWS' Good Morning America.
Ralls, a mechanic, says doctors never warned him or his wife that amputation of
the penis and testicles might have been part of surgery before he went in for
the procedure in November 1999. Ralls filed a negligence lawsuit against the
Clinics of North Texas in Wichita Falls, and the doctors who operated on him.
The civil case is set for trial Aug. 25.
"It was never even discussed. And I felt like he ought to have at least told us
that this might be a possibility so that we could have talked it over even
before he was admitted to the hospital," said Thelma Ralls, his wife. In a
February deposition, Ralls' doctor said that he determined the cancer had
spread to the penis while he was removing Ralls' bladder. Doctors did not send
a tissue sample to the lab until after the surgery. A Dallas doctor who
examined cell slides later found that Ralls did not have penile cancer.
The Ralls' case may sound outrageous, but for cancer patients across the
country, medical errors are something they — and many other hospital patients
— face with alarming frequency.
The Robert Wood Johnson Foundation reported in 2001 that 95 percent of doctors
have witnessed a major medical mistake, and that many of them involved cancer.
When Johns Hopkins reviewed tissue samples from thousands of cancer patients
around the country, they found one out of every 71 cases was misdiagnosed.
Both Breasts Removed, No Cancer
Frank Barerra is another cancer patient who was the victim of an error. He was
actually in surgery, about to have his prostate removed, when a call came from
the pathology department — there had been a mistake. His slides showed no
cancer.
"You can imagine — it was like waking up from a bad dream," Barerra said. "It
never occurred to me that a pathology lab could just bungle a decision like
that."
Last January, Good Morning America interviewed Linda McDougal, who was
misdiagnosed with breast cancer. McDougal was given a double mastectomy at the
United Hospital of St. Paul, Minn., in May 2002. After the surgery, McDougal
was told that she actually had no signs of cancer.
"My surgeon walked in and said that she had bad news, and she had no other way
of telling us other than to put it on the table. And that I didn't have
cancer," McDougal said. "And my immediate reaction was, great, you got it all.
And then she said, you don't understand. You never had cancer. And it was
instant shock. I couldn't even react to it."
When McDougal appeared on Good Morning America, the hospital that did the
operation offered an apology. Dr. Laurel Krause, a senior pathologist at the
hospital said that two patient slides at the hospital were inadvertently
switched.
"We deeply regret what happened, and wish we had made that clear at the time,"
Krause said. "At the time, Linda was very angry, and justifiably so."
But to victims of medical errors, sometimes an apology can't make up for what
they've lost.
"I really felt like they played God and took it in their hands and decided to
do it," Thelma Ralls said. "This is Hurshell's life, and my life. And to me
they destroyed our sexual life."
Understand Your Doctor
Dr. Rache Simmons, a breast cancer surgeon with Weill Cornell Medical Center in
New York, said that there are steps that patients can take to protect
themselves. First of all, patients should listen carefully to their doctors,
and all of their options and recommendations. If you don't understand your
doctor, get a new one, she advises.
"Part of being a good doctor is being able to communicate with your patients,"
Simmons said. "If you don't understand your doctor, and you've asked him or her
to explain it again and your still don't get it, find another physician."
Patients who are told they need surgery should also seek out a second opinion.
It makes good sense, and almost all health plans will pay for it. If the
opinions disagree, call your health plan and ask if they will pay for a third.
If they won't go with your gut on whether to proceed with the surgery, Simmons
said.
Once the decision is made, all patients should bring a family member or friend
to a pre-surgical appointment to write down information and ask questions.
"I give out hand-outs and videos at my practice because, as a breast cancer
surgeon, it's hard for anyone to be calm enough to take in all the information
at the appointment," Simmons said.
Ready for the Worst
It is also important for patients to designate someone as their health care
proxy before surgery, Simmons said. The patient-appointed proxy can carry out
the patient's wishes while the patient is under anesthesia.
Before going into surgery, patients sign a consent form, which they should read
very carefully before signing. The form will describe exactly what the doctor
is allowed to do, and whether a doctor will be allowed to proceed if more
serious conditions are found.
"It really boils down to a consent issue. So we as doctors can only do what's
in the consent form," Simmons said.
Another important document that patients should consider is a living will,
which can protect a patient's rights and wishes while they are under
anesthesia, in case the unexpected happens. Doctors need to know what they
should do in terms of extraordinary life-saving measures.