Tongue Cancer Misdiagnosis Lawsuits

• Connecticut – 2023 — $2,000,000 Settlement: A 69-year-old man died from metastatic tongue cancer following an alleged delayed diagnosis by Department of Veterans Affairs doctors. Initially, a neck X-ray and CAT scan indicated a mass at the base of his tongue, which was misinterpreted as a swollen spit gland. Despite the abnormality noted, the primary care physician prescribed antibiotics and did not refer him for further specialist evaluation. It took 18 months before a correct diagnosis of tongue cancer was made by an external specialist. He was then treated aggressively with radiation and chemotherapy at Yale New Haven Hospital but died less than two years after the correct diagnosis. The legal claim argued that earlier detection and treatment could have significantly increased his survival chances. The parties reached a $2 million settlement just days before the scheduled trial, after a negotiation from initial demands of $6 million by the plaintiff and a government offer of $900,000.
• South Carolina – 2021 — $2 million verdict: A 61-year-old man was referred by his local dentist to an oral surgeon to evaluate a lesion on his tongue, suspecting potential cancer. The oral surgeon attributed the lesion to a sharp wisdom tooth without scheduling a follow-up or expressing any urgency. Seven months later, due to pain, he revisited the dentist and was again referred to the oral surgeon. This time, the oral surgeon extracted the tooth and conducted a biopsy, diagnosing stage 3 squamous cell carcinoma. As a result, the patient underwent several surgeries, including the removal of lymph nodes and a significant portion of his tongue. He also underwent reconstructive surgery, six weeks of radiation, and chemotherapy. The patient, an airline pilot, had to forego the last three years of his flying career. He faced challenges relearning how to eat and speak and was concerned about a reduced life expectancy. His malpractice argued that if the lesion had been addressed as potentially cancerous from the start and followed up on promptly, the invasive cancer and subsequent treatments could have been avoided.  During the trial, the oral surgeon’s defense was that it was his routine practice to inform all patients about potential cancer risks. However, this claim was inconsistent with office records and communications with the referring dentist. An expert witness for the oral surgeon initially supported the surgeon’s actions but conceded, after reviewing medical charts, that the surgeon probably didn’t mention cancer because he didn’t suspect it. After a week-long trial, the jury awarded the patient $2 million which was reduced to $1.2 million due to a 40% comparative fault finding. Why did the jury also blame the patient?  The jury thought the man waited too long to address the problem.
• New York – 2017 — $2.4 million verdict: A woman died from oral cancer. Her family alleged that the physicians’ failure to timely diagnose tongue cancer caused it to metastasize, resulting in a glossectomy and a laryngectomy. This case settled for $2.4 million.
• Michigan – 2016 — $1.5 million verdict: A 67-year-old woman sought a dentist for her tongue lesion. The dentist interpreted the lesion as benign. Thirteen months later, the woman was diagnosed with oral cancer. She died about a year later. Her family alleged that the dentist’s failure to biopsy delayed her cancer diagnosis, resulting in her death. The jury awarded $1.5 million.
• Florida – 2007 – $6.4 million verdict: Plaintiff, a 51-year old social worker, was referred to defendant doctors regarding discomfort in his neck and throat. Defendants failed to diagnose tongue cancer and allegedly never came up with any conclusive diagnosis of plaintiff’s condition. Plaintiff later sought a second opinion from another doctor and was immediately diagnosed with tongue cancer. By that point, however, the cancer had advanced and plaintiff had to have his entire tongue removed. The surgery left him unable to speak or eat without assistance of a feeding tube. A jury in Broward County awarded $6.4 million in damages.
• Pennsylvania – 2003 — $4.1 million verdict: In this Philadelphia case the defendant ENT doctor was allegedly negligent in misdiagnosing the plaintiff’s tongue cancer. The misdiagnosis resulted in a significant delay in treatment. By the time tongue cancer was diagnosed it had spread significantly and plaintiff died soon after. The jury in Philadelphia awarded damages of $4.1 million.
• Tennessee – 2004 — $1.8 million verdict: Plaintiff was a 61 year old pharmacist and he went to the doctor complaining of persistent neck tenderness. An initial ultrasound showed a suspicious mass so a CT scan was performed. The radiologist interpreted the CT scan as normal and diagnosed the mass as an enlarged jugular vein. A year later the plaintiff’s neck pain was worse and was starting to impact his voice. He was referred to an otolaryngologist (ENT) who diagnosed plaintiff with hypopharyngeal tongue cancer (cancer at back of tongue). By then the cancer was in advanced stages and had already spread to the plaintiff’s chest and he died 16 months later. Subsequent wrongful death action was brought against radiologist and family doctor for failing to diagnose the cancer a year earlier which would have increased plaintiff’s survival chances. Jury in Nashville awarded $1.8 million.
• Florida – 2001 – $2.7 million verdict: Plaintiff is this case was a 74-year old truck driver. He went to his doctor about a lesion on his tongue and he was referred to defendant doctor for a biopsy. The defendant did not biopsy the lesion initially to determine whether it was cancerous. It was not until 7 months later that the defendant doctor actually took a biopsy and diagnosed plaintiff with squamous cell cancer of the tongue. During the 7 month delay the cancer grew from a T1 tumor to a T2 tumor. Following radiation treatment the cancer recurred and eventually grew to T3 at which point 75% of plaintiff’s tongue had to be surgically removed. The malpractice action alleged negligence in the delayed diagnosis of plaintiff’s tongue cancer resulting in a reduced prognosis and treatment options. Plaintiff rejected a settlement offer of $250,000 and went to trial where a jury in Dade County awarded $2.7 million.

Additional Thoughts on Tongue Cancer Malpractice Lawsuits

• Tongue cancer can spread two ways. There are little lymph channels that pick up excess fluid that then drain into lymph nodes. These are the same kernels that come up in your neck when you get an infection, and then eventually these empty back into the bloodstream.
• The 5-year survival rate for cancer in patients where the lymph nodes are involved is 64%. Another method that the cancer can spread is via the arteries that bring blood to the tongue. These cancer cells can then get into the body, break loose, and enter the general circulation sending them all over the body. If cancer has spread to a distant part of the body, the 5-year survival rate falls to 39%.
• Sometimes, tongue cancer is insidious, particularly cancer at the base of the tongue. In these cases, patients do not have any symptoms until the disease has reached an advanced stage. As the National Cancer Institute says that, “Tongue base cancers are among the most challenging tumors to manage. These neoplasms remain asymptomatic and hidden for quite some time before they are diagnosed, so most patients are seen at an advanced stage.”
• A lesion on the left lateral border of the tongue was the most likely area for tongue cancer so doctors should be particularly alert for that presentation.
• Squamous cell carcinoma, is the most common form of oral cancer. It accounts for more than 90% of all oral cancers. Squamous cell carcinoma develops from the squamous epithelium that lines the soft tissues of the oral cavity. The most common oral location for this cancer is the tongue. Chronic exposure to tobacco smoke is the major risk factor for oral squamous cell carcinoma.
• A common defense in any cancer misdiagnosis is causation. The doctor’s lawyer argues that even if the cancer had been caught in time, it would not have made a difference. This will certainly be the argument this ENT will make.