The wife of a retired naval chief petty officer, who was told by a doctor at the Naval Hospital in Bethesda that she was just "paranoid" about a recurring lump in her breast, has won a $1 million decision against the federal government for a misdiagnosis of what has become life-threatening cancer.
In what he called a "tragic case" of negligence, U.S. District Judge James R. Miller ruled late Wednesday in Baltimore that doctors who conducted a biopsy on Judith Burke, 36, of Manassas, erred in evaluating tests made in April 1981.
Doctors that month diagnosed the lump in Burke's left breast as benign.
It was not until October 1982, after Burke had made several follow-up visits and the lump had doubled in size, that doctors ordered another biopsy. They found cancer in the breast and in nearby lymph nodes, according to Miller's opinion.
A month later, doctors reviewed the original biopsy report and found the cancer had been evident then. Burke is now considered at high risk to suffer cancer again, according to court records. The records say that if the cancer had been removed after the first biopsy, Burke would have had a 90 percent chance of recovery.
Burke was never told about the error but had her left breast removed and underwent intense chemotherapy and radiation treatment at Bethesda. During a visit for one of those treatments, she happened upon a letter in her medical file that outlined the mistake.
"That stunned me," said Burke, a once-successful real estate saleswoman, the mother of a 14-year-old son and the wife of retired master chief petty officer James Burke. "They just never told me. I was just flipping through some papers when I saw that note."
"The reason we filed this suit," Burke said last night, "is you just can't let something like this go by. I would like to think what has happened to me will help somebody else not to trust implicitly and blindly. You've got to ask questions."
Bethesda hospital and Navy Office of Information officials declined to comment on the case. No information was available about the pathologist who reviewed the initial biopsy or the then-first-year resident, Dr. Bruce C. Davis, who received the pathology report. Davis, now a surgeon, could not be reached for comment and is no longer listed on staff at Bethesda.
"I don't think the judge nor I believe [Davis] did anything wrong," said Assistant U.S. Attorney Jack Tranter, who represented the government and pointed to the pathology report as the problem. Tranter said no decision about an appeal had been made and he did not know if any reprimand or corrective action had been taken in response to the error.
Burke, a native of New Zealand, noticed a lump on her breast in April 1981. Examined by doctors at Quantico Marine Base in Virginia, she was referred to the Naval Hospital in Bethesda for what was then called a "large cyst," court records show.
A firm lump, about two centimeters in size, was found by Davis and he ordered a biopsy. Both Burke and her husband were told the preliminary pathology reports indicated the tumor was benign. Davis told them a few days later that the final tests proved it benign. Burke was advised to examine her breasts monthly for lumps and to return for a checkup in three to six months. That November, Burke returned to the hospital. According to court documents, Bethesda hospital has no record of that visit and could not identify the doctor who examined her.
Burke, described by her lawyer William O. Snead as a "spunky lady," told the doctor she worried that the lump was growing. The doctor told her women who frequently develop benign lumps in their breasts -- fibrocystic disease -- are paranoid, Miller said.
Burke began experiencing chest pains and a numbness in her left hand and arm. A breast X-ray revealed a growth. A biopsy in October 1982 showed it to be malignant. The subsequent review and diagnosis of the previous biopsy prompted the breast removal and then a yearlong treatment of chemotherapy, followed by three months of chemotherapy coupled with radiation.
Tests from January through October 1984 reveal no cancer, according to the court documents.
"You kind of go one day at a time," Burke said last night. "I really feel as if I have to go with my life as if . . . [the cancer threat is] not there. In fact, I went to the doctor today and he found a few little lumps. That scares me. But most of all I'm angry. I'm angry this ever happened."