When Marlande Lazard traveled from Miami to Haiti on medical missions, she showed women how to pad their fingers around their breast and armpits in small circular motions to look for suspicious lumps. This could help them detect breast cancer early and save lives, she said.
Lazard was born in Port-au-Prince. When the Haitian army removed President Jean-Bertrand Aristide from power, she and her family were sent into exile. She was 21 when she moved to South Florida and she worked hard to become a nurse like her mother.
"I devoted my life to serve my savior Jesus Christ and to save lives both through my work in the hospital and during the medical missions," Lazard, 47, said. "Little did I know that I was walking around with this cancer while I was showing them how to perform the breast self-exams."
Lazard found a lump in her left breast, but for a while she didn't know it was cancerous. Eight doctors handled her case while she was misdiagnosed, according to her attorney Gary Friedman. By the time she learned that she had inflammatory breast cancer, it was too late.
Lazard recently won a $21.6 million medical malpractice verdict. But after Miami-Dade Circuit Judge John Schlesinger ruled in her favor, it was hard for Lazard to celebrate. Both the disease and the treatment have taken a toll on the single mother of two.
"She is still getting radiation therapy. The radiation has burned everything: Skin, soft tissue, and her ribs are crumbling," Friedman said. "She is always at risk for infection ... She has two children and she is trying to survive just another day for them."
The former emergency nurse was sharing her story, because she wants women to know the importance of getting a second and third opinion. She learned that even the most trusted doctors under the wrong circumstances are capable of making mistakes.
"If a woman finds a lump or any breast abnormalities, she needs to find a doctor who really cares and question everything," Lazard said. "Careless mistakes can be made."
For nearly a year, Lazard had several ultrasounds and a mammogram. It took a second opinion for her to undergo a biopsy, a closer analysis of tissue to detect cancerous cells. Without the biopsy results and an inaccurate screening, there was confusion since Lazard was breast feeding her son.
It's possible to mistake the rare inflammatory breast cancer with mastitis, an infection of the breast. The aggressive form of breast cancer and the breast infection share some of the same symptoms: redness, pain and a change in skin texture.
"There was some confusion about whether it was cancer or whether it was mastitis or whether it was both," Friedman said. "When in fact, she had clinical findings and radiological findings consistent with inflammatory breast cancer."
Friedman said a failure to track the abnormal finding during a follow-up screening was the real cause of the diagnostic error. There was a breakdown in communication between an ultrasound technician and Dr. James Domesek at Signet Diagnosis Imaging Services.
"They were not looking at the very first film showing the lump," Friedman said.
During the trial, Domesek's attorneys blamed the technician for failing to point the transducer over the area where the lump had been detected and for not noting the prior studies. The doctor looking at the images without talking to the patient faces the risk of making a determination without having all of the pieces of the puzzle.
Lazard's life-saving suggestion: "When you go to a place to get your test done, when they are doing it, make sure that you are talking to a doctor."
Once Domesek at the diagnostic center labeled the breast "benign," the primary care physician dealing with Lazard's symptoms started to consider other options, Friedman said. When the antibiotics prescribed didn't work, her doctor wanted to test her for autoimmune disease.
By the time Lazard got a second opinion July 2014, the doctor diagnosed her with incurable breast cancer. Lazard underwent a bilateral mastectomy, surgery to remove both breasts. She didn't have a good response to the chemotherapy, so doctors were using radiation therapy to deal with persistent recurrences.
"Sometimes the cure is worse than the disease," Friedman said about the side effects that Lazard has been enduring during treatment.
The judge assigned Signet Diagnosis Imaging Services 85 percent of the blame and Domesek 15 percent. Friedman said there was a confidential settlement with the other parties responsible, but he couldn't disclose the specifics. His son, Zachary Friedman, and John Sligman worked with him in the case.
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