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Pap Smear Litigation

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Medical Malpractice
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Abstract

This chapter reviews The Doctors Company experience with medical liability claims involving the Pap smear. The historical factors leading to the explosive growth in Pap smear litigation are discussed and an expert medical panel’s analysis of the sources of error in the Pap smear are presented in detail. The panel’s recommendations for reducing the Pap smear’s inherent false-negative rate, thereby decreasing patient injury from “missed” cervical cancers and their precursors, are reviewed. Finally, new technologies and strategies that enhance the Pap test’s sensitivity (liquid-based cytology and DNA testing for human papillomavirus) are presented.

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References

  1. Jones B. Rescreening in gynecologic cytology. Arch Pathol Lab Med 1995;119:1097–1103.

    PubMed  CAS  Google Scholar 

  2. Janerich D, Hadjimichael O, Schwartz PE, et al. The screening histories of women with invasive cervical cancer in Connecticut. Am J Pub Health 1995;85:791–794.

    Article  PubMed  CAS  Google Scholar 

  3. NCI Consensus Conference, April 1996.

    Google Scholar 

  4. Troxel D. Risk Management Guidelines for Cervical Cytology. The Doctors Company, 1997.

    Google Scholar 

  5. Claver C, Masure M, Bory J-P, et al. Human papillomavirus testing in primary screening for the detection of high grade cervical lesions. Br J Cancer 2001;89:1616–1623.

    Article  Google Scholar 

  6. Davey D, Zarbo R. Introduction and commentary, strategic science symposium on human papillomavirus testing. Arch Pathol Lab Med 2003;127:927–929.

    PubMed  Google Scholar 

  7. Frable W. Litigation cells: definition and observations on a cell type in cervical vaginal smears not addressed by the Bethesda system. Diagn Cytopathol 1994;11:213–215.

    Article  PubMed  CAS  Google Scholar 

  8. The 2001 Bethesda System, consensus statement, terminology for reporting results of cervical cytology. JAMA 2002;287:2114–2118.

    Google Scholar 

  9. Bonfiglio T. Atypical squamous of undetermined significance: a continuing controversy. Cancer (cytopathol) 2002;96:125–127.

    Article  Google Scholar 

  10. Boerner S, Katz R. On the origins of “atypical squamous cells of undetermined significance”: the evolution of a diagnostic term. Advances in Anatomic Path 1997;4:221–231.

    Article  Google Scholar 

  11. Fitzgibbons P, Austin M. Expert review of histologic slides and Papanicolaou tests in the context of litigation or potential litigation. Arch Pathol Lab Med 2000;124:1717–1719.

    PubMed  CAS  Google Scholar 

  12. “Requests for Pathology Specimens”—a TDC Risk Management Guideline.

    Google Scholar 

  13. Wright T, Cox J, Massad L, et al. 2001 Consensus Guidelines for the Management of Women With Cervical Cytological Abnormalities. JAMA 2002;287:2120–2137.

    Article  PubMed  Google Scholar 

  14. Davey D, Nielsen M, Frable W, et al. Improving accuracy in gynecologic cytology. Arch Pathol Lab Med 1993;117:1193–1198.

    PubMed  CAS  Google Scholar 

  15. June 1996 CAP Conference on “Liability and Quality Issues in Cervicovaginal Cytology,” Seattle. The entire proceedings are published in Arch Pathol Lab Med 1997;121:205–342.

    Google Scholar 

  16. Schiffman M, Solomon D. Findings to date from the ASCUS-LSIL Triage Study (ALTS). Arch Pathol Lab Med 2003;127:946–949.

    PubMed  Google Scholar 

  17. Lorincz A, Richart R. Human Papillomavirus DNA testing as an adjunct to cytology in cervical screening programs. Arch Pathol Lab Med 2003;127:959–967.

    PubMed  Google Scholar 

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© 2005 Humana Press Inc., Totowa, NJ

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Troxel, D.B. (2005). Pap Smear Litigation. In: Anderson, R.E. (eds) Medical Malpractice. Humana Press. https://doi.org/10.1007/978-1-59259-845-8_13

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  • DOI: https://doi.org/10.1007/978-1-59259-845-8_13

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-389-3

  • Online ISBN: 978-1-59259-845-8

  • eBook Packages: MedicineMedicine (R0)

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