The Story of Ryan Stephens
Ryan Stephens was a lovable, kind, 25-year-old married to his sweetheart, Courtney. People would describe him as a ‘gentle giant’ or ‘big teddy bear’. He worked at the Red Cross as a lab technician, and regularly volunteered to help with blood drives. A product of the foster care system, he carried hopes of starting a family of his own and adopting children one day knowing all too well there are so many kids out there who needed great parents. Everyone would describe him as an all–around a great guy.
In August of 2016, Ryan began feeling poorly – experiencing lethargy, weakness and just not himself. Also concerning was a lump on one of his testicles. He made an appointment with Kaiser Permanente to see his primary care doctor, Dr. Ford, to explain his symptoms and tell her about the lump.
During the appointment, Dr. Ford went into the electronic medical record and documented what Ryan reported to her and gave him a referral to see a urologist. However, she did not perform any physical examination of his scrotal contents or order an ultrasound test. This is significant because an ultrasound would have been the most effective way to determine if Ryan had testicular cancer. Instead, she made the referral, said goodbye and went off to see the next patient.
Ryan went home after the appointment feeling slightly relieved and with a hope that everything was a going to be okay. A few weeks later, he returned to Kaiser for his follow up with the urologist, Dr. Barry Mason. He told Dr. Mason the same information that he originally shared with Dr. Ford – that he felt an unusual lump on his testicles. Dr. Mason examined his testicles with his hands and felt around to see if he could feel a lump and said that he couldn’t feel anything. He dismissed Ryan and said he should go home and monitor himself and come back if he notices anything unusual. Again, Ryan was reassured by this prognosis and returned home without any sense of urgency about his situation.
About two months later, Ryan felt pain in his abdominal area. He returned to Kaiser to see Dr. Ford again and told her he had tightness and pain in the stomach area. Dr. Ford examined him and determined it was likely a musculoskeletal issue; most likely a strained or pulled muscle and she sent him home. At no time did she ask him about the testicular mass previously brought up, nor did she ask about the appointment with Dr. Mason.
Ryan’s symptoms continue and he returned back two months later, reporting pain in his lower back. Again, he was seen by Dr. Ford who quickly surmised he had probably pulled another muscle. He was discharged once again with a muscle relaxer. By now, months had passed since the first time Ryan saw Dr. Ford.
Fast forward one month to February. Ryan is at home with his wife watching television, when suddenly he was gripped with a pain that his wife describes as the worst she had ever seen. He couldn’t even stand up.
Courtney called 911 and an ambulance arrived about 20 minutes later. They put Ryan on a stretcher and rushed him to a different hospital and the doctor who saw Ryan took his medical history. Ryan explained the various encounters with his doctor over the past 6 months. They ordered the appropriate test, an ultrasound
The diagnosis: Ryan clearly had testicular cancer. Even more devastating was the fact that the cancer had spread to the liver. Within 3 weeks of his diagnosis Ryan became septic, which means he developed a blood infection because the cancer and the destruction of his organs. Tragically, he died at the age of 25.
The Case
Courtney could not understand how her husband returned to the doctor time and time and time again and nobody had ordered any kind of tests to figure this out. She wanted to know, was this preventable? Was there something that could have been done to save her husband?
Bell Law Firm set forth to uncover the truth.
Step 1: The first step was to get the medical records to see what they showed. We requested the records from Kaiser, we then had those records reviewed by some of the top experts in the country – urologists, primary care physicians, and the reports were all the same: that this was a legitimate case, and a case that should be pursued.
Step 2: We filed the lawsuit against Kaiser Permanente, Dr. Ford and Dr. Mason.
Step 3: We took depositions. The important thing about a medical malpractice lawsuit is it’s the only way that a patient can force healthcare professionals to talk to them under oath, to explain what happened. This pursuit of the truth is what Courtney wanted more than anything. She just wanted to know if the doctors that treated Ryan did everything possible, and within the standard of care.
Through depositions, we learned neither Dr. Ford nor Dr. Mason ordered an ultrasound. Young, white males are the highest risk group for testicular cancer. If a man is between the ages of 15 and 30 reporting any kind of lump in their scrotal contents, it is presumed to be cancer unless proven otherwise. Testicular cancer is a very treatable disease if detected early – with a cure rate of over 95%. If it isn’t detected, it can and will metastasize, leading to catastrophic outcomes.
Another key element to this case took place during depositions, specifically depositions of Kaiser’s technology specialist. We had set up a deposition of this individual and required him to bring a computer so we could specifically see the electronic medical record and see how it worked in order to better understand better why Ryan was not tested for testicular cancer. There were two pieces of the software we wanted to see:
- Ryan’s medical record as it actually looks in the electronic record
- What information was contained in the software that might have a bearing on Ryan’s treatment. For example, we asked the IT specialist, “what happens when a doctor puts in an order to a specialist, a urologist?”
He demonstrated using a ‘John Doe’ patient and showed how the order would be entered. He entered the information into the software, and another screen opened up where the doctor would enter the name of the specialist and the reasons for the referral to that specialist.
When that data is entered, something else extremely critical appears on screen. Practice guidelines.
To learn about the significance of the practice guidelines, continue reading in Part 2.