Failure to Diagnose Prostate Cancer Attorney NYC

How Prostate Cancer Is Diagnosed

Prostate cancer diagnosis involves screening, biopsy, and pathology:

• PSA (prostate-specific antigen) blood test: The primary screening tool for prostate cancer. PSA is a protein produced by the prostate gland, and elevated levels can indicate cancer (though they can also indicate benign prostatic hyperplasia, infection, or other non-cancerous conditions). PSA screening is typically recommended starting at age 50 for average-risk men, earlier for high-risk men (African American men, men with a family history).
• Digital rectal examination (DRE): A physician examines the prostate through the rectum to feel for abnormalities (nodules, hardness, asymmetry). DRE is less sensitive than PSA but can detect some cancers that do not elevate PSA.
• MRI of the prostate (multiparametric MRI): An increasingly important tool for evaluating suspected prostate cancer. MRI can identify suspicious areas and guide targeted biopsy. It is used when PSA is elevated but prior biopsies were negative, or to assess the extent of known cancer.
• Prostate biopsy: The standard for definitive diagnosis. A urologist uses a needle (typically guided by ultrasound -- TRUS, or by MRI fusion) to obtain tissue samples from the prostate. Usually 12-14 cores are taken from different regions of the prostate.
• Pathology (Gleason score and Grade Group): Tissue samples are examined by a pathologist under a microscope. The pathologist assigns a Gleason score (ranging from 6 to 10) and a Grade Group (1-5) that describe the aggressiveness of the cancer. The Gleason score and Grade Group are critical for treatment decisions.
• Imaging for staging: CT scan, bone scan, or PSMA PET scan to determine whether the cancer has spread beyond the prostate (staging).
• Molecular and genetic testing: For advanced prostate cancer, testing for certain genetic markers (BRCA1, BRCA2, MSI status) may guide treatment decisions.

Common Ways Prostate Cancer Is Misdiagnosed

Prostate cancer misdiagnosis can occur at any point in the diagnostic process:

• Failure to screen: A primary care physician or urologist fails to recommend PSA screening for a patient who should be screened (age 50+ for average-risk men, earlier for high-risk men).
• Failure to investigate elevated PSA: When a PSA test is elevated, the standard of care requires further evaluation -- typically referral to a urologist for consideration of prostate biopsy. Failure to investigate an elevated PSA may constitute negligence.
• Failure to repeat an abnormal PSA: A single elevated PSA may be due to non-cancerous causes (BPH, infection, recent ejaculation). The standard of care may require repeating the PSA before proceeding to biopsy, but failure to follow up on a persistently elevated PSA is negligence.
• Failure to biopsy when indicated: When PSA is elevated, when DRE is abnormal, or when MRI shows a suspicious lesion, the standard of care requires a prostate biopsy. Failure to biopsy may allow cancer to go undetected and progress.
• Inadequate biopsy: The biopsy does not sample enough cores, does not sample the region containing the cancer, or uses inadequate technique. This can lead to a false negative -- the patient is told there is no cancer when there is.
• Failure to repeat biopsy after a negative result: If PSA remains elevated after a negative biopsy, the standard of care may require repeat biopsy or MRI-targeted biopsy. Failure to repeat may miss cancer.
• Failure to use MRI-guided biopsy: When prior biopsies were negative but PSA remains elevated, MRI of the prostate can identify suspicious areas for targeted biopsy. Failure to use MRI-guided biopsy may miss cancer.
• Pathology errors: The pathologist misinterprets the biopsy tissue -- missing cancer that is present (false negative), diagnosing cancer when it is not present (false positive), or misclassifying the Gleason score or Grade Group. Under-grading (calling a high-grade cancer low-grade) can lead to undertreatment.
• Failure to communicate or follow up: Abnormal results are not communicated to the patient or referring physician, or follow-up appointments are not arranged. [Link to: /radiology-errors/communication-failures]

Screening and the Standard of Care

The standard of care for prostate cancer screening in New York includes:

- PSA screening discussion: The standard of care has evolved from routine PSA screening for all men to shared decision-making -- physicians should discuss the risks and benefits of PSA screening with patients starting at age 50 (average-risk men), age 45 (high-risk men, including African American men and men with a family history), or age 40 (men with a strong family history). - Investigation of elevated PSA: When PSA is elevated (typically above 4.0 ng/mL, though the threshold varies), the standard of care requires further evaluation -- typically referral to a urologist for consideration of biopsy. The physician should also consider repeating the PSA, evaluating for non-cancerous causes (BPH, infection), and using additional tests (free PSA, PSA velocity, PSA density) to assess risk. - PSA velocity: A rapidly rising PSA (more than 0.75 ng/mL per year) is concerning for cancer, even if the absolute level is not very high. Failure to recognize a rising PSA may constitute negligence. - Follow-up after negative biopsy: If PSA remains elevated after a negative biopsy, the standard of care may require repeat biopsy or MRI-guided biopsy. - Symptomatic patients: Any patient with symptoms concerning for prostate cancer (difficulty urinating, blood in urine or semen, bone pain, erectile dysfunction) should undergo evaluation.

Failure to recommend screening, failure to investigate elevated PSA, failure to biopsy when indicated, or failure to follow up after a negative biopsy may constitute negligence.

PSA Testing Errors

PSA testing is the primary screening tool for prostate cancer, and errors in PSA testing or interpretation can lead to missed diagnosis:

- Failure to order PSA: The physician does not order a PSA test for a patient who should be screened. - Failure to follow up on elevated PSA: The PSA is elevated but the physician does not refer the patient for further evaluation or biopsy. - Failure to repeat elevated PSA: A single elevated PSA may be due to non-cancerous causes. The standard of care may require repeating the PSA, but failure to follow up on a persistently elevated PSA is negligence. - Failure to recognize PSA velocity: A rapidly rising PSA is concerning for cancer, even if the absolute level is not very high. Failure to track PSA over time and recognize a rising trend may constitute negligence. - Failure to use additional tests: When PSA is in an intermediate range (4-10 ng/mL), additional tests (free PSA, PSA density, PSA velocity, urinary PCA3 test, prostate health index) can help assess the risk of cancer. Failure to use these tests may constitute negligence. - Failure to refer to a urologist: Elevated PSA or abnormal DRE should prompt referral to a urologist for further evaluation. Failure to refer may constitute negligence.

Biopsy and Pathology Errors

Biopsy and pathology errors are a significant cause of prostate cancer misdiagnosis:

- Sampling error (false negative biopsy): The biopsy needle does not sample the region containing the cancer. Standard TRUS biopsy takes 12-14 cores from different regions of the prostate, but cancer may be in a region not sampled. A false negative biopsy can delay diagnosis. - Inadequate number of cores: Taking too few cores increases the risk of missing cancer. The standard of care typically requires at least 12 cores. - Failure to use MRI-guided biopsy: When prior biopsies were negative but PSA remains elevated, MRI-guided biopsy (MRI-US fusion biopsy) can target suspicious areas identified on MRI. Failure to use MRI-guided biopsy may miss cancer. - Pathology false negative: The pathologist misses cancer that is present in the biopsy tissue. The patient is told the biopsy is negative, and the cancer goes untreated. - Pathology false positive: The pathologist diagnoses cancer when it is not present, leading to unnecessary treatment (surgery, radiation). - Under-grading: The pathologist assigns a lower Gleason score or Grade Group than is warranted, leading to undertreatment. For example, calling a Gleason 7 (Grade Group 3) cancer a Gleason 6 (Grade Group 1) may lead to active surveillance when treatment is needed. - Failure to test for molecular markers: For advanced prostate cancer, testing for certain genetic markers (BRCA1, BRCA2, MSI status) may guide treatment decisions.

An independent pathologist should review the slides in any case of suspected pathology error. [Link to: /medical-malpractice/pathology-errors]

When Prostate Cancer Misdiagnosis Constitutes Malpractice

Prostate cancer misdiagnosis constitutes medical malpractice when a healthcare provider deviated from the accepted standard of care and that deviation caused harm. This includes:

• Failure to screen: A physician failed to recommend PSA screening or discuss screening with a patient who should be screened.
• Failure to investigate elevated PSA: An elevated PSA was not followed up with referral to a urologist, repeat PSA, or consideration of biopsy.
• Failure to biopsy when indicated: When PSA was elevated, DRE was abnormal, or MRI showed a suspicious lesion, biopsy was not performed.
• Inadequate biopsy: The biopsy did not sample enough cores, did not sample the region containing the cancer, or used inadequate technique.
• Failure to repeat biopsy after a negative result: PSA remained elevated after a negative biopsy, but no repeat biopsy or MRI-guided biopsy was performed.
• Failure to use MRI-guided biopsy: When prior biopsies were negative but PSA remained elevated, MRI-guided biopsy was not used.
• Pathology errors: The pathologist missed cancer, misclassified the Gleason score or Grade Group, or failed to test for molecular markers.
• Failure to communicate or follow up: Abnormal results were not communicated, or follow-up was not arranged.

The Impact of Delayed Prostate Cancer Diagnosis

The impact of a delayed prostate cancer diagnosis can be devastating:

- Stage progression: A cancer that could have been diagnosed while confined to the prostate (5-year survival: over 99%) may progress to metastatic disease (5-year survival: 32%) due to delayed diagnosis. - Spread beyond the prostate: Prostate cancer commonly spreads to the bones, lymph nodes, and other organs. Metastatic prostate cancer is treatable but not curable. - More aggressive treatment: Later-stage cancer requires more aggressive treatment -- hormone therapy (androgen deprivation), chemotherapy, immunotherapy, and targeted therapy. - Loss of treatment options: Some treatments (radical prostatectomy, radiation therapy) are most effective for localized disease. Once the cancer has spread, these options may no longer be curative. - Reduced survival: The most devastating consequence. A patient who could have been cured may face a terminal diagnosis. - Quality of life impact: More aggressive treatment causes more side effects -- incontinence, erectile dysfunction, hot flashes, fatigue, bone pain, and emotional trauma. - Loss of chance: Even if the patient is not yet terminal, the delayed diagnosis may have reduced their chance of survival. [Link to: /delayed-diagnosis-lawyer/loss-of-chance]

Lavern's Law and Your Deadline to File

Prostate cancer misdiagnosis cases in New York are subject to Lavern's Law, which provides a discovery rule for cancer cases. Under Lavern's Law:

- You have 2.5 years from the date you discovered (or should have discovered) the misdiagnosis to file a lawsuit. - There is an absolute outer limit of 7 years from the date of the negligent act.

This means that even if years have passed since the misdiagnosis, you may still have a valid claim if you discovered the error recently. For example, if you were diagnosed with metastatic prostate cancer in 2024 and discovered in 2025 that a urologist failed to biopsy an elevated PSA in 2020, you would have 2.5 years from the date of discovery to file.

Lavern's Law applies only to cancer cases. [Link to: /misdiagnosis/laverns-law]

If the misdiagnosis occurred at a municipal hospital (NYC Health + Hospitals), shorter deadlines apply. [Link to: /hospital-negligence/suing-nyc-h-h]

If the misdiagnosis resulted in death, a wrongful death claim under EPTL 5-4.1 must be filed within 2 years of the date of death. [Link to: /wrongful-death-lawyer]

Common Defense Arguments and How We Counter Them

Defense: The PSA was only mildly elevated, and the standard of care does not require biopsy for every elevated PSA.

Defense attorneys use several arguments in prostate cancer misdiagnosis cases:

• Our Counter: While not every elevated PSA requires immediate biopsy, the standard of care requires investigation of elevated PSA -- typically repeat PSA, evaluation for non-cancerous causes, and referral to a urologist. For persistently elevated or rising PSA, biopsy is indicated. We use expert testimony to establish that the physician should have investigated or biopsied based on the specific PSA values and trends.

Defense: The biopsy was negative, so there was no cancer to find.

Our Counter: A negative biopsy does not definitively rule out prostate cancer -- particularly if the biopsy did not sample the region containing the cancer (sampling error). If PSA remained elevated after a negative biopsy, the standard of care required repeat biopsy or MRI-guided biopsy. Failure to follow up on a persistently elevated PSA may constitute negligence.

Defense: The patient did not follow up on recommendations.

Our Counter: If the physician recommended follow-up and the patient did not comply, the patient may share responsibility. However, if the physician did not communicate the need for follow-up, or if abnormal results were not communicated, the physician may be liable. We examine the medical records to determine what was recommended and communicated. [Link to: /radiology-errors/communication-failures]

Defense: Prostate cancer is slow-growing, so the delay did not change the outcome.

Our Counter: While some prostate cancers are slow-growing (and may be managed with active surveillance), others are aggressive. The Gleason score and Grade Group determine the aggressiveness. We use expert testimony to establish that the cancer was aggressive and that the delay allowed it to progress. The loss of chance doctrine may also apply. [Link to: /delayed-diagnosis-lawyer/loss-of-chance]

Compensation Available in Prostate Cancer Misdiagnosis Cases

A successful prostate cancer misdiagnosis claim in New York can provide compensation for:

• Medical expenses: Additional surgery, radiation, hormone therapy, chemotherapy, immunotherapy, rehabilitation, ongoing care
• Lost wages and loss of earning capacity
• Pain and suffering: Physical pain, emotional distress, loss of enjoyment of life (NY has no cap on non-economic damages)
• Permanent disability: From incontinence, erectile dysfunction, bone metastasis, and other complications
• Loss of chance of survival: The reduced chance of survival caused by the delayed diagnosis
• Wrongful death damages: If the delayed diagnosis caused death [Link to: /wrongful-death-lawyer]

What to Expect Working with MDLaw Firm

When you contact MDLaw Firm about a potential prostate cancer misdiagnosis case:

• Free Consultation: We listen to your story and review the basic facts.
• Immediate Deadline Assessment: We evaluate the Lavern's Law deadline (2.5 years from discovery, 7-year outer limit).
• Record Retrieval: We obtain all PSA test results, biopsy records, pathology slides, imaging studies, and medical records.
• Expert Urology Review: We engage board-certified urologists to evaluate whether the standard of care was met.
• Expert Pathology Review: We engage independent pathologists to review the biopsy slides.
• Causation Analysis: We use oncologist expert testimony to establish that the delayed diagnosis caused the cancer to progress and reduced survival.
• Litigation: We file within Lavern's Law deadlines and handle all aspects of discovery and trial.
• Resolution: We pursue maximum compensation through settlement or verdict.

Frequently Asked Questions

The value of a medical malpractice case in New York depends on several factors, including the severity of the injury, the strength of liability evidence, and the economic and non-economic damages involved. New York is one of the few states with no caps on medical malpractice damages, meaning there is no artificial limit on what you can recover. Below are typical settlement ranges based on injury severity.