This case involves a 52-year-old woman in Florida with a history of prolonged sun exposure who consistently visited a dermatologist for treatment of moles. The patient presented to the dermatologist with lesions on her neck, cheek, chest, and foot. The dermatologist assessed the lesions as actinic, applied liquid nitrogen to the lesions, and took biopsies. The biopsy returns as an early form of easily treatable skin cancer. Although the dermatologist treated the patient with cryotherapy, the patient’s lesions returned after several months. Another biopsy was taken which came back as squamous cell carcinoma. The dermatologist then treated the lesions with topical anti-tumor medication and lesion freezing. The patient returned 6 months later to report non-healing on all the lesions. The dermatologist applied liquid nitrogen to the lesions but did not take biopsies. In the months that followed, the patient returned to the dermatologist for several freezing treatments with minimal changes. Finally, a biopsy was taken more than a year later. The biopsies returned a malignant stage 4 melanoma on the patient’s chest. In spite of immediate invasive treatment, the patient succumbed to her cancer within the year. It was alleged that the dermatologist’s failure to diagnose the patient’s melanoma led to the patient’s death.
Question(s) For Expert Witness
- 1. Please describe your experience in treating patients with similar conditions.
Expert Witness Response E-026642
I am a professor and vice chair of dermatology at a major university. I also ran the residency training program at my university medical center for over 7 years. I see patients with a wide variety of skin disorders, including many patients with melanoma and other skin cancers. I have extensive familiarity with the standard of care for treating patients who present with these conditions. I also serve in leadership capacities with several national dermatology and physician organizations.