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"I Was in Total Shock"
Lenore Janecek was headed toward her Chicago home on a September afternoon in 2000 when she received a call on her cell phone that would change her life forever. It was her doctor. He told her that the test results from her routine colonoscopy two weeks earlier revealed she had intestinal cancer. Stunned, Janecek, 61, pulled over. "There must be a mistake," she insisted. But the doctor, a gastroenterologist, assured her there was no mistaking the diagnosis. Janecek would need immediate surgery.There are few things more dreaded than a cancer diagnosis. But for Janecek, the news was doubly traumatic: She had been successfully treated for intestinal cancer ten years earlier, so the thought that the disease had come back was terrifying.
On September 26, in a procedure that lasted three hours, the surgeon made an incision running the length of Janecek's abdomen and removed about two feet of her small and large intestines. The surgery was an ordeal, but at least, she thought, the worst was behind her. In the weeks that followed, however, Janecek, a mother of two who ran her own health insurance consulting firm, became concerned that her recovery was not going well. The pain and digestive troubles were worse than she'd expected. She wondered if they'd gotten all the cancer.
Then, at her six-week checkup with the gastroenterologist, Janecek received ominous news: She might have been the victim of an error at the hospital lab. A genetic test later confirmed that the tissue sample her diagnosis was based on had been contaminated with cancerous cells from another patient's specimen. Janecek did not have cancer. Her surgery had been unnecessary. "I was in total shock," she recalls. "First shock, then anger."
It turned out that the gastroenterologist had questioned the initial lab result, but the lab's review of its procedures still failed to uncover the error. Janecek sued the hospital for negligence and won a $3 million award from the jury. But six years after her ordeal, she continues to suffer bouts of severe abdominal pain and other digestive symptoms stemming from the surgery. "It's like someone punched me as hard as they could right in my abdomen, and I didn't see it coming," she says. "And I will have that for the rest of my life."
When most people think of medical errors, they think of the sensational cases -- the surgeon who removes the wrong organ, or the patient who dies because he was prescribed the wrong drug. In fact, it's been estimated that medical errors may cause up to 100,000 deaths each year in this country. But stories like Janecek's highlight a problem that hasn't gotten as much attention: errors that occur in pathology labs, where tens of millions of blood samples, biopsies and tissue specimens are analyzed every year, and radiology labs, where a mislabeled MRI or a misinterpreted x-ray or CT scan can have dire consequences for a patient.
No one knows for sure how many lab errors happen annually. Most mistakes are reported on a voluntary basis, and many are never reported at all. Experts are quick to emphasize that the vast majority of medical tests are error-free. But errors do add up, given the huge volume of testing nationwide. For example, a typical large medical center does some 5 million clinical pathology tests each year.
It's not just the amount of testing that makes mistakes inevitable. It's also the complexity of the process. Testing starts in the doctor's office or at the lab, where a specimen is drawn and labeled or an image is taken and ID'd. It then is analyzed and interpreted by the experts. Finally, the results are sent back to the doctor to aid diagnosis and treatment. Errors at any step along the way can threaten your health -- or even your life. Paul N. Valenstein, a pathologist at St. Joseph Mercy Health System in Ann Arbor, Michigan, knows of a case in which a patient died when a lab did not get his test results to the right doctor in time, even though the results were accurate.
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