When Ovarian Cancer Is Misdiagnosed as IBS in Oregon

Ovarian cancer does not always announce itself. The American Cancer Society says that "Early ovarian cancer often causes no symptoms."¹ It also says that "Women are more likely to have symptoms if the disease has spread, but even early-stage ovarian cancer can cause them."² When symptoms do appear, they can resemble everyday stomach trouble. The American Cancer Society notes that these symptoms "are also commonly caused by benign (non-cancerous) diseases".² When a symptom is attributed to another condition, the diagnosis can be delayed.

This article explains, in plain terms, why these symptoms get missed, what a workup can involve, and how a delayed diagnosis can affect a medical-malpractice claim under Oregon law. It is educational only. It does not tell you whether you or a loved one has a claim.

Symptoms that get blamed on your gut

The American Cancer Society lists four of the most common symptoms of ovarian cancer: bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, and urinary symptoms such as urgency or needing to go often.³ The Society notes: "These symptoms are also commonly caused by benign (non-cancerous) diseases."⁴

There is a difference, though. When ovarian cancer causes these symptoms, they tend to be persistent and to represent a change from normal, happening more often or more severely than before. The Society suggests seeing a doctor when symptoms like these occur more than 12 times a month.⁴ The National Cancer Institute makes the same point: these signs "also may be caused by other conditions," so they are not proof of cancer, but they still deserve attention when they persist or get worse.⁵

Why CA-125 and transvaginal ultrasound matter

When an ovarian problem is suspected, two tests that can be part of the workup are a CA-125 blood test and a transvaginal ultrasound.⁶

CA-125 measures a protein that is often higher in people with ovarian cancer. But it is not a simple yes-or-no test. Many benign conditions, including endometriosis and pelvic inflammatory disease, can raise CA-125, and not every ovarian cancer causes a high level.⁷ The National Cancer Institute puts it plainly: an increased CA-125 level "can be a sign of cancer or another condition such as endometriosis."⁸ A normal result does not rule cancer out, and a high result does not confirm it.

A transvaginal ultrasound uses sound waves to make images of the ovaries and nearby organs. It can find a mass and show whether it is solid or fluid-filled, but it cannot tell on its own whether a growth is cancer or something harmless.⁹ Neither test confirms cancer by itself. The Society explains that tests for ovarian cancer "typically include a combination of imaging, biopsy, and blood tests," and that a biopsy "is needed to confirm the presence of cancer and determine its type."¹⁰

When the workup falls below the standard of care

A missed or delayed diagnosis raises a legal question: how did the care compare with the standard Oregon law sets?

For physicians, Oregon law sets that yardstick, referred to here as the standard of care. Under ORS 677.095(1), a physician licensed by the Oregon Medical Board has "the duty to use that degree of care, skill and diligence that is used by ordinarily careful physicians in the same or similar circumstances in the community of the physician or a similar community."¹¹ The comparison is with ordinarily careful physicians in the same or similar circumstances.

In an ovarian cancer case, a lawyer would look at what the physician knew and when. Were the symptoms persistent and worsening rather than occasional? Was there a family history of ovarian cancer, which the National Cancer Institute identifies as increasing the risk of ovarian cancer?¹² Did the physician order or consider a CA-125 test, a pelvic or transvaginal ultrasound, or a referral, or were ongoing complaints written off as IBS without further workup? The legal question is whether the care met the ORS 677.095(1) standard described above.

How a delayed diagnosis affects an Oregon claim

A malpractice claim also turns on whether the failure caused additional harm. With cancer, the harm alleged can be the difference a delay made: a tumor that spread to a higher stage, treatment that became harder or less likely to succeed, or a shorter life expectancy. That question can involve comparing the likely outcome at the time the diagnosis should have been made with the actual outcome after the delay.

Oregon also sets deadlines for filing. ORS 12.110(4) provides that "An action to recover damages for injuries to the person arising from any medical, surgical or dental treatment, omission or operation shall be commenced within two years from the date when the injury is first discovered or in the exercise of reasonable care should have been discovered."¹³ In Gaston v. Parsons, 318 Or 247 (1994), the Oregon Supreme Court held that "injury," as used in ORS 12.110(4), "consists of three elements: (1) harm; (2) causation; and (3) tortious conduct." The court held that the period "begins to run when the plaintiff knows or in the exercise of reasonable care should have known facts which would make a reasonable person aware of a substantial possibility that each of the three elements (harm, causation, and tortious conduct) exists."¹⁴

The same subsection sets an outer limit. Notwithstanding ORS 12.160, every such action must be commenced within five years from the date of the treatment, omission or operation. If no action was commenced within five years because of fraud, deceit or misleading representation, the action must be commenced within two years from the date that fraud, deceit or misleading representation is discovered or in the exercise of reasonable care should have been discovered.¹⁵ How these deadlines apply depends on specific dates and facts.

When a delayed diagnosis leads to death, the claim changes form. A wrongful-death action is brought by the personal representative of the deceased person's estate, for the benefit of the surviving family members the statute names. Under ORS 30.020, that action generally must be commenced within three years after the injury causing death is discovered or reasonably should have been discovered. The outer limit is not simply three years from the death: the action may not be commenced later than the earliest of three years after the death or the longest other statute of ultimate repose that applies, which expressly includes the five-year repose in ORS 12.110(4).¹⁶ In a missed-cancer case, the five-year malpractice repose can therefore expire before three years have run from the death.

Because these rules turn on specific dates and details, people worried about a missed or delayed ovarian cancer diagnosis can have an Oregon attorney review the facts and deadlines before time runs out.

This article is educational

This article describes Oregon law in general terms. It is not legal advice and does not create an attorney-client relationship.

Time limits matter. Most Oregon personal-injury and auto-accident claims must be filed within two years of the injury or accident. Medical malpractice claims must be filed within two years of when you knew or reasonably should have known of the negligence, with an outer limit of five years from the act itself (with a fraud exception). Wrongful death claims must be filed within three years of the date of death. Claims against public bodies (cities, counties, state agencies, public hospitals) require a notice of claim within 180 days. Missing these deadlines typically ends a case.

If you think you may have a claim, call Huegli Law at 971-317-6436 for a free case review. Todd Huegli is licensed in Oregon and consults on cases in Oregon only.

Footnotes

1. Ovarian Cancer Early Detection, Diagnosis, and Staging — American Cancer Society. https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/how-diagnosed.html ↩

2. Signs and Symptoms of Ovarian Cancer — American Cancer Society. https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/signs-and-symptoms.html ↩ ↩²

3. Signs and Symptoms of Ovarian Cancer — American Cancer Society. https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/signs-and-symptoms.html ↩

4. Signs and Symptoms of Ovarian Cancer — American Cancer Society. https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/signs-and-symptoms.html ↩ ↩²

5. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancers Treatment (PDQ)–Patient Version — National Cancer Institute. https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq ↩

6. Ovarian Cancer Early Detection, Diagnosis, and Staging — American Cancer Society. https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/how-diagnosed.html ↩

7. Ovarian Cancer Early Detection, Diagnosis, and Staging — American Cancer Society. https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/how-diagnosed.html ↩

8. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancers Treatment (PDQ)–Patient Version — National Cancer Institute. https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq ↩

9. Ovarian Cancer Early Detection, Diagnosis, and Staging — American Cancer Society. https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/how-diagnosed.html ↩

10. Ovarian Cancer Early Detection, Diagnosis, and Staging — American Cancer Society. https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/how-diagnosed.html ↩

11. ORS 677.095 — Duty of care; legal issues not precluded by investigation or administrative proceeding. https://oregon.public.law/statutes/ors_677.095 ↩

12. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancers Treatment (PDQ)–Patient Version — National Cancer Institute. https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq ↩

13. ORS 12.110 — Actions for certain injuries to person not arising on contract. https://oregon.public.law/statutes/ors_12.110 ↩

14. Gaston v. Parsons, 318 Or 247 (1994) — Caselaw Access Project. https://static.case.law/or/318/cases/0247-01.json ↩

15. ORS 12.110 — Actions for certain injuries to person not arising on contract. https://oregon.public.law/statutes/ors_12.110 ↩

16. ORS 30.020 — Action for wrongful death. https://oregon.public.law/statutes/ors_30.020 ↩