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HMO Liability / Medical Malpractice / Failure to Diagnose Cancer

Posted in on September 4, 2017 - Confidential

Jeanne T. Anderson v. Prudential Health Care Plan of Georgia, Inc., Meridian Medical Group, Inc. and Gregory Teel, M.D., State Court of DeKalb County, Georgia. This was a failure to diagnose breast cancer case against the plaintiff’s HMO and her treating physician. Rather than refer the plaintiff to a specialist for treatment/surgery of a suspicious breast lump, the primary care physician continued to follow that over a period of one and a half years, by which time it was finally diagnosed as invasive carcinoma.

Plaintiff proved that the failure to refer was encouraged by the HMO’s internal policies, procedures, and incentives designed to limit referrals so as to increase revenue, which documents were produced only after a series of court orders requiring the same.