Had C difficile cleared before chemotherapy?

THE DIAGNOSIS WAS BREAST CANCER for a 54-year-old woman. In May 2006, a surgeon performed a mastectomy and prescribed postoperative antibiotics.

In July, the patient became ill and was treated for Clostridium difficile infection. She began a course of chemotherapy in August, after telling her oncologist about the earlier infection. The patient later developed acute colitis and underwent emergency colectomy. She has a permanent ileostomy, has had 14 additional operations, and continues to suffer complications of severe colitis.

PATIENT’S CLAIM The surgeon was at fault for prescribing antibiotics after mastectomy. The oncologist was negligent in failing to test for C difficile before starting chemotherapy. The antibiotics caused C difficile infection. Because her immune system was compromised by chemotherapy, C difficile caused colitis.

PHYSICIANS’ DEFENSE The surgeon’s defense was not reported. The oncologist claimed he was not negligent; he questioned whether the patient had C difficile infection at all.

VERDICT The surgeon settled for an undisclosed amount before trial. A $4.5 million Oklahoma verdict was returned against the oncologist.