The hospital had advised him of the risks prior to the transplant and then again after the cancer was discovered. There is a medical doctrine called informed consent. The patient was informed of the risks and went ahead with the operation to start with. The patient then elected to keep the infected kidney. While I feel sorry for this man's family, the hospital does not appear to have done anything wrong. None of the doctors, or the hospital, or even the women herself knew about the cancer when the transplant was performed. The transmission of disease is a risk that is disclosed to all transplant recipients.

Wrong JS the cancerous kidney was known by the doctors AFTER it was put into the patient. So he wasnt given any notice of the risks of uterine cancer.

Then when the patient had it removed suddenly like a miracle they dicovered he had the cancer after telling him he didnt for so long AND telling him the risk was minimal. Obviously the risk was NOT minimal.

They informed him of the risks of uterin cancer AFTER the kidney was put in his body.

Maybe they should test organs for these things BEFORE putting them in peoples bodies rather than AFTER.

Just a thought.

They inform all transplant candidates that there is a risk of disease transmission. Any kind of disease. He could have caught something else from the transplant. He caught cancer. Very sad but not the hospital's fault.

And they can't do a whole lot of testing on the organs beforhand because they are in a hurry. Very small window of time you know.

ya... a great victory for the death panels!!!

hospital management and insurance companies are the death panels we have heard so much about in the news (you thought that the health-care reform would create them....we had them already!!!)

You have to remember whenever giving ANY consent for any health concern, that when they tell you there is a 1% risk of dying, that is exactly what it means - there is a 1% chance of dying.......if you are the 1% of the population having the procedure that dies - you are 100% dead.....not just 1% dead. He was well informed, and gave consent, as we all do when undergoing any surgery or procedures that we need for a quality life. There will always be that 1% (or 2% or 10 % - whatever the risks are)..... but that doesn't make the hospital or doctor liable when a patient dies if they have done everything correctly and as safely as possible under the circumstances, and followed all hospital policies and transplant policies.....there are all kinds of things that can happen.....just as we take risks when flying, or driving, or riding a motorcycle......we weigh the risks against benefits and take the chances that we choose to. You also have to remember that these transplants become available in other hospital facilities and the transplant coordinators match them up with patiients all over the country in different hospitals, testing is done quickly and matched up, surgically removed, then flown within hours to the facility close to the recipient's location to be surgically implanted. If the donor woman didn't even have symptoms and did not know, nor did her family or doctors know that she had uterine cancer when she died, there would be no way to find that out in time. Only on autopsy would it be found, which would have been done after the harvesting of organs and transplantation into the recipient.

Why can't the hospital screen the bodies for cancer before they harvest the organs? Just a thought? I feel so sorry for this man and his family.

There's no time to screen

The hospital did everything by the book, but life isn't always fair and this time the patient got the short end of the stick in life... sucks, but it's not really anybody's fault. Sometimes, crap just happens without anyone to blame for it.

and Liew's surgeon, Dr. Thomas Diflo, didn't learn about her cancer until about six weeks after the transplant.

Liew decided to keep the kidney after Diflo concluded there was only a slim chance he'd be sickened by the feminine cancer. He ultimately had the kidney removed in August 2002 but died the next month of a cancer his autopsy said came from the donor.

His widow said the hospital should have urged him to have the organ removed immediately.

So what more was the hospital to have done? They informed him and told him the risks. He opted to keep the kidney. What did his widow want them to do? Knock him out and rip the kidney out? Doesn't work that way.

This is very sad all around, but I'm glad the jury found for the hospital! They did what they could!

cball
hospital management and insurance companies are the death panels we have heard so much about in the news (you thought that the health-care reform would create them....we had them already!!!)

ya... a great victory for the death panels!!!

Are you making the assumption that the doctor's knowingly gave him an infected kidney?

What ignorant comments some people make. The article said they estimate that 1 percent of transplants are suspected of transmitting illness. One percent. If you were facing your impending death and were offered a donor organ that could save your life, would you turn it down? My daughter's recipients are still alive, 9 years later.

I bet people who are alive and well today because of transplants think they are somewhat miraculous.

I guess common sense isn't so common.

You hit the nail on the head! It's amazing how stupid people can be. People who are awaiting transplants are out of options. I can't imagine anyone who is at death's door turning down a transplant if the chance of transmission of disease is only 1%. The following statement appeared in an earlier article about this case:

"Some 23 transplant recipients in 2007 — out of about 28,000 recipients nationwide that year — were judged to have at least possibly contracted cancers, HIV, tuberculosis and other diseases from their donors, according to a 2009 article in the American Journal of Transplantation."

That translate to 0.082% of tranplant patients that year who possibly became ill from a disease transmitted with the new organ. The article goes on to state that 12 of those 23 patients died, which is 0.043% of the total transplant recipients for 2007 who died due to an illiness that was contracted by the transplant. If I had been on dialysis for four years, I'd take those odds anytime over certain death from failure of my own kidneys.

BTW, sorry for the loss of your daughter.

Ben Birdsey,

The principal of law is so old that it is not even written down. No one can be held responsible for what they cannot be reasonably expected to know. In this case, the donor had no idea at the time of her death that she had cancer and that the cancer had metastasized. This was a high risk procedure for the patient and he was undoubtedly informed of not only the known risks but the possibility of unforeseen consequences.

To be a criminal act there needs to be a criminal intent and one cannot plead that they did not know a criminal act was against the law and protection is that it must be proven to the point that a prudent man would have no doubt.

To find civil guilt, there is a much lower standard of proof, that the act happened by the preponderance of the evidence --- that 51% of the evidence supports guilt. But the protection in the case of civil law is that the guilty party must have had a reasonable path that would have avoided the act. That the act (the transmission of cancer) had no reasonable way of being predicted, pretty much ends the suit right there.

An example would be that if you were driving home from having a brand new set of tires put on your car and one blew out for no foreseeable reason and you struck and killed a pedestrian. There would be no civil or criminal case there. But if you were driving and the only difference was that you had bald tires and one blew and the same pedestrian, there would be both a civil and possibly a criminal case there. The law allows for the fact that the future cannot be foreseen with perfect clarity.

For those people who espouse tort reform and think that somehow courts and juries always give huge awards, this case should be instructive because it is far more typical. In this case, both sides lost. There were no winners. A woman died, but did the right thing by being an organ donor. A man was given a transplant intended to save his life. The surgical team and hospital did everything right. But the man, with a compromised immune system because of the transplant, died of a rapidly spreading cancer. And no one was at fault.

This is an excellent example of why we do not need tort reform that favors insurance companies over victims and insures that those truly negligent are not punished. Medical malpractice is the 5th leading cause of death in this country. It is not even in the top 10 in any other country in the world. So, there is a reasonable presumption that some form of malpractice may have been involved, especially since the patient's death was so precipitous.

But in this case there was no malpractice by anyone. And an untimely death is still a tragedy.

Sorry that I am a little late to respond, but there is a legal principle called "duty of care" that would supersede "informed consent".

If the hospital was specifically negligent in determining the medical history of the transplant source, if they were specificall7y negligent in testing the transplant material, or if they delayed the discovery of the possible transmission of cancer in a way that affected the prognosis of the patient then they DID violate their implied responsibility of "duty of care."

According to the article, every single one of these criteria are violated.

cancers are classified based on the tissue of origin, because that is what often dictates its behavior, prognosis, and treatment.

"feminine" cancer? I think they mean "female."

Either way, it's a b*tch.

Thanks to grundik for the clarification.

Agree.

Umm... am I hearing this right? You want them held responsible when anything fails in an organ transplant? It's a super risky thing to begin with. He wanted to keep the kidney even though he knew there was a small risk. And yes, small risk does mean risk. Duh. He took the risk and it didn't pay off for him. It's too bad but you can't blame the hospital. They told him the risk.

The biggest mistake ever made was to be 100% in total belief that his doctor/surgeon is always right. He made the error in judgement to think that the doctor knows everything. There was an article a long time ago that I read although your doctor has your best intentions in mind (mostly), the patient has to research and think out these topics themselves as well. Any form of cancer is bad cancer, I don't care if you are a man and you got an organ infected with a female type cancer, it's STILL CANCER!

You just don't toy with your own life like that! The doctor did advise him that he could get infected, he may have said chance, but you can get infected, that should have been a red light right there.

But regardless, he had the kidney removed, by then it is too late. As soon as that kidney was transplanted in, the blood worked its way through his body. Guess what, he was probably infected the second all that was hooked up. As the article states, no one knew such an infection existed until 6 weeks after the transplant.

It seems likely that the medical team would have explained the situation to the patient and let him make the call because Mr. Liew had to be emotionally ready for further surgery and treatment. One has to wonder how much "fight" the patient had in him; he was diabetic and had been on dialysis for 4 years. His doctor must have been concerned about the outlook for this patient regardless of the choice he made when the cancer was discovered; Mr. Liew was a patient at risk with or without more surgery.

It is the family that seems to be having a hard time coping with their loss - and lawyers are making them think that money will make it easier to bear. This sounds like one of those sad situations where all the advanced medicine couldn't make things turn out fine.

Doctors can find the most healthy of organs and there is still a risk involved. Hell, there's a risk giving birth and having your tonsils out! The jury made the right call in this case!

Attitudes like the one displayed in #4 are why healthcare in this country is so unbelievably expensive!!! Almost all hospitals operate in the red so where do you suppose any settlement money would come from? FROM OTHER PATIENTS! Why should I have to pay because this guy decided to take a risk in keeping a cancer infected kidney??

Transplant patients are made well aware that there is always a chance that it won't work or that there could be complications. Most take the risk because without the transplant they likely would die of whatever disease they have that put them in the situation to need a transplant.

I have to take issue with the idea that the doctor or patient assumed that the doctor is "right" all the time. I have heard many people say "those doctors don't know everything they think they do." Truth is, they know exactly how much they don't know, they just don't know as much as some people think they do. Whenever they are honest and say "we really don't know what will happen for sure" somebody pipes up with "see, I told you!"

Remember, someone having any type of organ transplant is severely ill, and near death. Any procedure that is done is more risky than it is for you or I. Having the transplant alone is massive surgery, and the immunosupressive medications have enormous side effects. Having the kidney removed could have been even riskier than contracting the cancer. People at this stage of renal disease are gaining quality of life, not a cure. Keeping the infected kidney probably had as much chance of being successful as having it removed.

I have chatted with a couple of surgeons about this (my wife is a PhD medical researcher, so our circle of friends is a little top-heavy with medical people.) Both indicated that once the uterine cancer had spread to the kidney, that there were free cancer cells in the man's bloodstream almost instantly and that a decision to keep or not keep the kidney was irrelevant. One issue that did effect the use of chemotherapy, radiation and other treatments would have been that the man's natural defenses would have been suppressed by the anti-rejection drugs.

Transplant organs are routinely tested for a number of diseases such as AIDS and Hepatitis, but to test for cancer cells would have been such an expensive, hit-and-miss, and time-consuming process that the transplant could never have taken place with that much delay. Because immuno-supressant drugs are given in conjunction with transplants, medical people are well aware that even mild conditions that the body would just normally shrug off can kill, so they are as careful as they can practically be in this situation. It's a high-risk, high-benefit type of surgery.

this is what they deem, defend and support as "acceptable standards of health care"

What is? Because the link just has national statistics about MRSA... you're attacking a single hospital by using national statistics and without a single case of unacceptable standards AT THAT SPECIFIC HOSPITAL.

Where does it say that his doctor advised him to have it removed?

Liew decided to keep the kidney after Diflo concluded there was only a slim chance he'd be sickened by the feminine cancer. He ultimately had the kidney removed in August 2002 but died the next month of a cancer his autopsy said came from the donor.

That's what I read. Was the hospital going to remove the infected kidney and furnish a new one without charging Liew or his insurance? It's funny because if you have diabetes you cannot be an organ donor. How do they miss that someone has uterine cancer for six weeks?? That's complete negligence on the part of the hospital.

The donor died of a heart attack! Obviously showing no signs of cancer! There was no reason to presume that her organs weren't healthy. Other than the heart!

And from that same paragraph, yes, it sounds as if the doctors said, hey there's a risk, you should have this removed. He chose to keep it!

Uterine cancer is slow growing, and shows symtoms of bleeding in women. I know because I had this cancer. My question is, was this cancer spread out of the uterus? Then the 50 year old should have had an idea that something was wrong. However, she may have thought that this was a normal problem for someone going through the change.

Unfortunately even if they had removed the transplanted kidney as soon as it was discovered the donor had cancer there would be no guarantee that the recipient would not have already been infected with the donor's cancer. He still could have ended up dying from it.

Do you know how long some people wait to get a kidney? It is because it has to be a perfect match. So they were supposed to rip the kidney out and replace it with what? Nothing? It's not like another perfect match was just going to pop up. Besides, I don't see that the hospital did anything wrong. Lawsuits like this are the reason insurance is so expensive in the first place. He got a transplant but NO ONE knew the donor had uterine cancer. Even the donor didn't know. It wasn't found out until AFTER the transplant had been done. There is nothing the hospital could do.

he was still taking immune suppressing medication. With no immune system cancer grows faster.

Agreed Laurel. I knew a woman who had breast cancer. She was offered a treatment that had a potential side effect of leukemia. It was like a .5%. She took the treatment. Guess what? She got leukemia and was dead within 2 years. You just don't take any risks!

LS - you must be a male. Any woman with breast cancer who is offered a treatment with only a 0.5% chance of side effects is going to take the risk. Without treatment, there is a 100% chance of dying from cancer.

Nope, I'm a female. She was offered a mastectomy too! That would have saved her life. It wasn't like this was the only option! And a .5% risk of leukemia? Nope! I wouldn't take it unless there were no other options!

You didn't mention that your friend was given the option of a mastectomy. The inference of your post was that the treatment with the potential side effect of leukemia was her only choice. Even with a mastectomy, there is no 100% guarantee that the cancer won't return. All it takes is a for a few cancer cells to be left behind during the surgery. The fact of the matter is that none of us knows what course of treatment we would take for any given disease unless we find ourselves in the unfortunate position of having to make a choice. Liew was diabetic and had been on dialysis for four years before he received the kidney transplant. In other words, he had suffered for a long time before the transplant surgery. It's quite understandable that he would choose the option of keeping the kidney if his doctors felt that there was a low chance of contracting cancer from the diseased organ.

As for posters who feel that the doctors and hospital are at fault, exactly what advantage do you think that it would offer them to give Liew bad advice? The fact of the matter is that the circumstances in this case are extremely rare. It's possible that this is the only one of it's kind and that there was no precedent on which to base a prognosis. All they could do was offer the best advice they could based on their experience.

You just don't take any risks!

There's no way to go through life without any risks. You try to minimize the risks as best you can and weigh the benefits against the risks to come to conclusions on what to do. That's all any of us can do... but eventually life's little risks catch up to us all.

Death sometimes has no reason, and we, as reasonable people, need a reason for just about everything. I can't imagine watching my loved one go through what this patient, and his family did, then seemingly get a miracle, only to have that miracle go bad. Grief has many forms and wanting to place blame is part of the process......nothing more. Just part of the process, just like funerals are not for the deceased, but for the living. All part of this culture of ours. I'm so sorry for the family's loss, my heartfelt condolences to them.

LEGIT??? REALLY??? So, you want us to do PET scans on every donor to look for an unknown cancer before we donate their organs? Gee, that'll be cost effective, and give you nice fresh organs to transplant!!! Hope you never need a kidney if they change the rules as you think they should!!! I wonder if you live in the part of Georgia where that teacher got railroaded, because she wore short-shorts while mowing her lawn, and because her students were playing doctor.

Apparantly in GA they think that people with no medical training or experience whatsoever should be the ones that determine medical proceedures... kinda like how they think people with no education or background in science should write their biology textbooks.

So what do you think the hospital shoud have done? Screen the patient before transplanting? After a person dies there is a very small window of time that you can transplant an organ before it too dies. That is not enough time to screen for cancer or HIV or TB or any other bad disease. Even if there were enough time to do a CT scan on a recently dead donor there is no way of detecting cancer in its early stage when it is just a clump of cells and therefore not visible with the current level of technology.

Do you think that they should have taken back the kidney against the patient's desire? Even then there is no guarantee that the patient won't end up with cancer because 1) it was weeks before it was discovered that the donor had cancer and 2) the cancer could have been transfered on the day that the transplant occured.

The hospital did everything by the book This lawsuit was a case of a lawyer looking for another 30% of what they could get if the hospital settled. Nothing in life is a sure thing and if he was already on dialysis for four years he didn't have much time anyway. I'm sorry for the widow but where does the 3 million dollar value come in? I'm sure that he wouldn't have earned 3 mil in the amount of time he had left.

The donor was fifty and died from a stroke. Most likely the stroke was from blood clots from her undiagnosed cancer. Her physician should be arrested for manslaughter in her death and the deaths of the people who recieved her organs. The justice department were she lived should obtain her medical records.

I had a endometrial biopsy dec 11 2009. the physician kept sample in the office all weekend then sometime on monday had tissue delivered to the hospital and lied on the form that tissue was removed dec 14 2009. the lab finally tested tissue dec 15 2009.

The tissue was normal or was it? I have donated blood since that incident and will continue to thin out my own blood thru regular donations. Critical d-dimer means blood clots which i have physicians all have ignorred this blood test result. The lawyer i spoke with said i need to find a physician who will say the tissue was damaged by the weekend delay. I am and have been ill in bed since the surgery. when i die my organs may infect others with my unknown disease. Yes all donors should have pet scans or better yet when patients are deathly ill get the pet scans prior to them dying. just my opinion. the medical system is very bad.

True, Diane. My father died of lung cancer. I was stunned when they said it had been in him for twelve years before it suddenly went aggressive and killed him in less than 6 months. An amazing thing was that three years before it killed him, he'd had a heart attack and underwent a successful quadruple bypass operation. Even though his chest was opened up, the surgeons never saw the cancer. Judging from some of the stupidity on this discussion board, I guess my mother should have sued the doctors who saved his life from the heart attack because they never saw the cancer in the organ right beside the one they were working on.

I agree with you Steve and condolences for your loss. I just wanted to say that when they open up a chest to do coronary artery bypass they do not open up the lungs and therfore would not have sen what was growing in them.

Diane: Metastatic cancer cells often mutate to such a degree that their origin is not discernible. I recall several patients from my years in med school with such cancers, widely metastatic when detected, where the source was never determined. Genetic typing has improved dramatically since then but I'd imagine this is still fairly common, particularly among those on immunosuppressives (which block the body's natural ability to heal itself, including genetic "errors").

Also, not all allopathic physicians are evil, though the education can try to push us in that direction :)

BRCA genes are involved in breast and ovarian cancers, not uterine. This was a very unfortunate outcome, but it doesn't mean it was anyone's fault. Jury did a good job.

and if full history of donor was not known, they erred

The donor had no history of cancer, she died of a heart attack and had never been diagnosed with cancer.

You must work for Biocurex or own part of the company.

Low cost wouldn't have mattered... it would have taken a FAST screening to prevent tradgedies like this one from occurring. The doctors don't have very long before they need to get the organ into the patient or the organ will die (it is dieing every second it's not in the patient).

One thing that might prevent this is "artificial" organs grown from the patient's own stem cells though. Seems like a good reason to fund stem cell research.

fast screening for cancer? someone said cancer is chronic and the donor had to have had it for years. The question is why was her cancer ignorred? How many other people have cancer and do not know it? Who reaps the money o right the insurance companys they get the monthly premiums and do not have to pay for treatments. They know the patient will die with or without the treatments so they have started to not diagnose in the first place. Have you seen the new guide lines for cancer testing?

Rick, spend a week in medical school and I'll bet your opinion changes. Ever heard of the word "metastasize"? You will learn about it if you go to med school.

Excellent point, Ben. What is it with these people who have probably never had a course in biology making statements like "uterine cancer" does NOT change into "other types of cancer"? Rick, maybe you should post the title of the article, the authors and the name of the scientific journal in which it was published from which you learned that medical gem.

Rick: look up "tissue of origin" . I know you mean well, but you are uninformed bud.

Cancers are oftened named according to the organ that it originated from. A man can have prostate cancer that spreads to his bones and someone else can have colon cancer that spreads to his liver. Breast cancer can spread to you brain.

Ben, you speak of the missing piece here. How advanced was the lady's cancer? Had it metastasized beyond the uterus? Was it in the blood stream? The doctors did not know what would happen, and should not have predicted that there was only a slim chance of spread because they were in unfamiliar territory. Estrogen is usually fuel for this cancer, but men have some estrogen in their bodies also. Women also have some testosterone in their bodies. This cancer usually stays confined to the uterus for a long time, but the article did not mention how much the autopsy reported on the spread of the cancer. My guess is that the cancer was in the blood stream.

Rusty, when breast cancer spreads to your brain, it has the characteristics of where it started. These doctors were working in unfamiliar territory, and did not know what would happen. They should not have said that there was a slim chance because they didn't know what the chances were. Something is missing here. Did the autopsy show that the cancer had spread beyond the uterus? Then the cells could have been in the blood stream.

WTF?

lol she was dead her family donated. it does not mention what status was on her driver liscense. the transplant teams put pressure on familys when they are grieving. they want to do a transplant and pay for car and house payments like most people in a hurry to get the job done. this time they erred by not checking her medical history it is as simple as that. i wonder why my vet can put a needle into a dog draw out some blood look immediately at the blood under a microscope and say "Your dog has cancer" we need to cut off the leg to save his life. Why are people physicians so lame?

If your vet can take your dog's blood and tell you immediately that your dog's leg needs to be removed, then it is your vet that is ripping you off!

The time to transplant organs is measured in minutes. You want to waste that time on what, the vast majority of the time, are wild goose chases in a totally deluded and futile effort to remove all risk from life? If you're in need of an organ, you are already in dire medical condition and I daresay anyone looking down the barrel of dying of the medical condition that has made an organ transplant needed changes their perspective just a bit.

It's this sue-obsessed, "if something goes wrong, someone is to blame and must pay me" mentality that has made medical care so costly to begin with. While modern medicine has allowed people to live for entire lifetimes after illnesses or injuries that just a few generations ago (or even a few years ago, in some cases) would have killed them prematurely, it does not confer infallibility, 100% positive outcomes or prevent an eventual death of something.