It started like a bad joke. The surgeon entered Linda McDougal’s hospital room last June and said she had good news and bad news. McDougal, a 46-year-old accountant from Woodville, Wis., who was recovering from a double mastectomy, tensed. The surgeon told her she didn’t have cancer—which brought a sense of relief to McDougal, who assumed that meant doctors had gotten all the malignancy. The bad news? “She said, ‘You never had cancer,’ ” recalls McDougal. ” ‘There was a mistake.’ ”
McDougal was stunned to learn that a pathologist had mixed up her test results with those of another woman. As horrible as that was, her pain was compounded when President Bush announced in January that he was advocating a cap of $250,000 on the pain-and-suffering portion of medical malpractice claims. So McDougal, the mother of three sons, decided to go public with her ordeal and lobby against the White House legislation. “I think maybe I’m supposed to be a face for this issue,” says McDougal. “Maybe I can speak for people who can’t.”
Eight months later McDougal voices outrage when she describes the missteps that lead to her needless double mastectomy. Last May she had gone to United Hospital in St. Paul, 45 miles from her home, for a needle-core biopsy after a routine mammogram disclosed a suspicious shadow on one breast. A few days later her doctor called with the chilling news that she had cancer. McDougal and her husband, Jerry, 41, a machinist, quickly arranged to meet with surgeons in St. Paul to weigh the options, which ranged from a lumpectomy to a single or double mastectomy. The couple considered the options and did research on the Internet. Linda recalls asking both the general surgeon and the plastic surgeon what they would do in her circumstances. “Neither hesitated,” says Linda. “Both replied, ‘I’d have my breasts removed.” ‘ The McDougals concluded that the double mastectomy offered the greatest hope of survival. “I wanted to do whatever gave her the best chance of living,” says Jerry. “I wanted my wife.” But, in all their calculations, what the McDougals didn’t do was wonder if the original diagnosis was the result of error. Says Linda, who now advocates questioning all test results: “It never dawned on me to have the pathology report checked.”
After Linda’s operation her breast tissue underwent another round of tests, which showed no trace of disease. The pathologist, who has not been named publicly and who worked as part of a group on contract with the hospital, subsequently determined that there had been a mix-up of Linda’s medical paperwork with another patient’s tissue slides. As a result, the diagnosis of cancer was correct, but for the wrong woman. (According to a hospital spokeswoman, the patient who did have cancer later had a lumpectomy and is now cancer-free.) The surgeon readily told McDougal of the mistake, and the pathologists and hospital say they instituted new safeguards within days. However, citing the pathologist’s 10-year “exemplary” record, they did not discipline her beyond notifying various oversight groups and including the incident in the doctor’s file.
But that’s not enough for Linda, whose three sons range in age from 15 to 28. In the aftermath of the operation, she struggles with recurring infections and has serious problems with the drainage of fluid in her body. She is also facing several more follow-up operations for reconstruction. Meanwhile she must constantly deal with the heartache of 31 in. of scars that stretch across her chest. “Some days she gets out of the shower in the morning, catches a glimpse of herself in the mirror and starts to cry,” says Jerry. “It breaks my heart.” As Linda says, “I feel freakish. Clothes don’t fit right.”
There is almost nothing about President Bush’s proposal that suits her either. The legislation would essentially draw a distinction between claims involving medical liability and other types, for which there would continue to be no cap on awards for pain and suffering. “If I’d lost my breasts in a factory accident, I could get millions,” says Linda. Doctors and insurance companies argue that restraints have to be imposed on the awards, which have helped escalate medical costs and even forced some blameless physicians to give up their practices because of hefty insurance premiums. But McDougal, who expects to file her own suit, is unmoved: “I challenge President Bush to ask his wife or his mother or his daughters, if this happened to them, would $250,000 be enough?”
Yet for all her anger Linda knows that things could be worse, a point emphasized by her son, Jacob, 15. “He said, ‘But Mom, you don’t have cancer,’ ” she recalls. “For him that’s what counted—I’m alive. And I’m grateful for that.”
Margaret Nelson in Woodville