This case takes place in New York and involves a middle-aged male patient who had a significant history of gastrointestinal illnesses and had undergone several surgical procedures on both his small and large intestines over the course of his life. As a precaution against colon cancer, the patient underwent regular colonoscopies administered by his gastroenterologist. During one of these colonoscopies the plaintiff’s doctor noticed a number of polyps, some of which were removed and biopsied while others were marked with tattoos should they need to be removed later. The biopsied polyps came back negative for malignancy, however there was still a suspicion of cancer. Following a subsequent colonoscopy in which it was noted that some of the polyps had moved and grown, the plaintiff’s doctor referred him to a general surgeon for a bowel resection. During the procedure, the general surgeon noted that he could not detect any polyps or tattoos, and the patient was closed without the removal of any tissue. Some time after the procedure, the plaintiff saw another gastroenterologist who performed a colonoscopy. The gastroenterologist noticed several polyps during the procedure, as well as tattooed markings, and indicated that all of the polyps could be removed without surgery.
Question(s) For Expert Witness
- 1. Do you currently treat patients like the one described in this case?
- 2. Is it a potential deviation to fail to locate the previously tattooed polyps and remove?
- 3. Have you ever reviewed a similar case in the past?
Expert Witness Response E-008574
My expertise is in colorectal cancer and polyps. I have extensive experience treating patients like the one described in this case and have authored book chapters and articles on this subject. It might have been a deviation from the standard of care not to remove the previously tattooed polys. I would need to review the medical records to opine further. I have reviewed a similar case in the past and would be happy to review this case.
Expert Witness Response E-006318
I am board certified in Colon and Rectal Surgery and in General Surgery and routinely treat patients like the plaintiff in this case. It is not a deviation from the standard of care not to remove the tattooed polyps. Tattoo can fail to be placed subserosally and may therefore not be identifiable from the serosal (intraperitoneal) view. Tattoo can also migrate over time, making identification of a previously tattooed location unclear. I have reviewed a similar case in the past and would be happy to review this case.