Is Your Hospital Reading Pap Specimens Correctly?
The great majority of Pap specimens are adequate specimens that are interpreted as normal. An adequate specimen is one in which there are a sufficient number of cells, including endocervical cells represented. Yet, among those adequate specimens are ones where an existing disease process, such as a precancerous lesion or cancer, are not represented because those cells were not harvested in the sample taken by the gynecologist. This is simply a sampling deficiency that occurs and is not medical malpractice.
A woman who is diagnosed with cervical cancer and who had a Pap specimen or specimens taken in the last few years before the diagnosis that was interpreted as normal should have the slide or slides reviewed. Though the greatest number of those Paps, interpreted as normal in women with a disease process, will have been read properly, meaning that the sample did not have the cells, there are many cases involving an interpretation error by a cytotechnologist or a pathologist at the lab.
We Can Spot Errors In Your Pap Specimen Report
Mr. Caputo promptly has reviewed many Pap slides for clients who have a cervical cancer diagnosis, and consequently has handled many cases in which the Paps in the last year to five years were misinterpreted. Labs only keep the slides interpreted as normal for the required period of five years. Therefore, it is important to obtain those slides without delay.
Many women do not realize that their Pap slides are not evaluated by a pathologist who is an M.D., but rather by a cytotechnologist who can screen up to 80 slides per day. Only slides with questionable cells or a recognized abnormal appearance are transferred to a pathologist for evaluation.
Understanding The Different Types Of Pap Test Errors And Their Impact On Diagnosis
Pap smear testing remains a cornerstone of cervical cancer screening in thena, detecting precancerous changes before they develop into invasive disease. However, multiple error types can occur during the screening tests process, each carrying distinct implications for patient health and potential medical malpractice liability.
False-Negative Vs. False-Positive Results
A false-negative pap test occurs when abnormal cells are present in the specimen, but the laboratory reports the test as normal. This represents the most dangerous error type since it creates false reassurance, delaying diagnosis and treatment while precancerous lesions progress to invasive cervical cancer. Women receiving false-negative results continue their normal screening intervals rather than undergoing necessary follow-up procedures like colposcopy or biopsy. By the time the next pap smear detects abnormalities, the disease may have advanced significantly, reducing treatment success rates and survival chances.
False-positive results, conversely, occur when laboratories interpret normal cells as abnormal. While these errors cause unnecessary anxiety and additional procedures, they do not typically result in delayed cancer diagnosis or medical malpractice claims since they prompt further investigation rather than delaying it.
Specimen Adequacy Vs. Interpretation Errors
Pap test errors fall into two distinct categories requiring different analysis. Specimen adequacy issues arise when gynecologists fail to collect sufficient cells or do not sample the transformation zone, where precancerous changes typically develop. These sampling deficiencies mean abnormal cells never reach the laboratory for evaluation, making accurate interpretation impossible regardless of the cytotechnologist’s skill. While frustrating, sampling errors generally do not constitute laboratory negligence.
Interpretation errors, however, occur when adequate specimens containing abnormal cells are misread as normal by cytotechnologists or pathologists. These mistakes represent preventable failures in the diagnostic chain and form the basis for medical malpractice cases. Reviewing clinical history alongside slides helps identify interpretation errors, particularly when patients later develop cervical cancer despite recent normal screening tests.
Technical Errors In Pap Test Processing
Beyond interpretation failures, technical errors compromise cervical screening accuracy. Specimen mislabeling may result in patients receiving incorrect results, potentially missing abnormalities, while others undergo unnecessary procedures. Contamination during slide preparation can introduce foreign cells, obscuring actual findings. Inadequate fixation or staining affects cell appearance, making accurate evaluation difficult. Processing delays can degrade specimens before examination.
Human papillomavirus testing often accompanies modern pap smear protocols, and coordination errors between cytology and HPV results can lead to inappropriate management recommendations.
Standing Up For You When The Hospital Won’t
Mr. Caputo has obtained settlements in many cases in which the failure to diagnose a precancer abnormality has allowed cancer to develop.
In one most tragic case, a wife and mother of teenage children was diagnosed with final stage metastatic cancer of the cervix. After obtaining her slides that were available, it was determined that the two specimens earliest in time were found abnormal but were not reported to be as serious as they indeed were. The test was repeated as required, but on a second repeat in the following year, the cytotechnologists at the lab failed to detect what was a clear abnormality. At a separate lab, the next three Paps were misinterpreted as normal when they showed developing cancer. The young housewife and mother died within nine months of her diagnosis.
Many defenses are interposed by the labs in this type of case, and our Pittsburgh office has faced all of those, leading to successful settlements of the cases. Contact John A. Caputo & Associates, P.C., today for your free initial consultation regarding errors with Pap specimens. Dial 412-593-5973 or send a private email.