It is every woman's nightmare. Connie Chatwood Hull received a Pap smear test that showed no cancer only to learn 15 months later that the lab apparently had made a mistake.
By then, the malignancy had sent its tendrils through her abdomen, forcing Hull to undergo extensive surgery, which left her unable to lift her two young children for three months. By then, the Tarzana laboratory that she believes overlooked the abnormal cells had been closed by state inspectors, who found widespread test inaccuracies.
Hull and her husband filed suit against the lab, Central Pathology Medical Services Group, and her doctor, Dr. Elizabeth Irwin of Torrance. Earlier this month their case suffered a setback when the state Supreme Court ruled that they could not seek punitive damages because they had not shown that they were likely to be awarded extra money as a result of those damages.
Although Hull's attorneys have vowed to find a way around the ruling and continue seeking $4 million in damages, it was a blow to her and to other women who have sued the lab for such alleged errors.
"It was terrible, terrible, terrible, terrible what happened to her and what happened to me and she should be allowed to punish them," said Julita Cardenas, a 52-year-old lab assistant from El Monte who underwent extensive cancer surgery three years after Central Pathology told her she was tumor-free.
Cardenas' family asked her not to divulge details of her traumatic ordeal. But court records show that she did not learn that the 1984 Pap showed a precancerous condition until after her hysterectomy, after radiation treatments had damaged her bowels and bladder, and after news reports about the lab prompted her doctor to have the tests re-examined.
Pap smears are a routine scraping of cervical cells that women are advised to undergo annually. Viewed through a microscope, the scrapings can reveal cancer and other diseases in their early stages, when less extreme measures--such as laser surgery--often can be employed.
Attorneys representing Central Pathology did not return telephone calls last week. But Superior Court files show that in Southern California, at least five lawsuits alleging that the lab bungled Pap smear tests have been pursued since 1988.
A search of court records in other states indicate there could be dozens of similar suits across the country against the lab, which evaluated nearly 700,000 Pap smears annually, making it one of the nation's largest so-called "Pap mills." The state, which inspected the lab in spring, 1989, found that 21% of a random sampling of tests had been misread, well above the 5% margin of error generally expected in the industry.
The five Southern California lawsuits reflect the human fallout from the lab's practices, which state investigators said included encouraging technicians to read too many slides a day, issuing results even when specimens were damaged, and mixing up patients' slides. The women who sued claim that they learned of the lab's errors through coincidence or persistence, that hundreds of other women may not know that their cancer could have been detected earlier or that such a mistake merits legal action.
The suits are filled with similarities even though the women are different, ranging in age from 24 to 56 and in occupations from attorney to nurse. All of the suits document the grief that followed the cancer diagnoses, then the disbelief that followed news that the disease might have been halted in an earlier stage if the first Pap readings had been accurate.
The women all have said, through interviews and in their court depositions, that the experience radically changed their lives. Surgery and worry interrupted education and careers. Scars and pain linger and some women have become cancer phobic, calling the doctor with any ache or pain.
"I was driving to the doctor the other day and I heard that Don Henley song, 'The End of the Innocence,' and I thought: 'That about sums it up. This was the end to my innocence,' " said Hull, 38.
Of the five suits, only Hull's and one filed by Karen McIntosh are pending in the courts. In three other cases, including Cardenas', the women settled out of court for $300,000 or less.
Because of the $250,000 limit for pain and suffering in medical malpractice cases, except for the rare award of punitive damages, the women's lawyers said they had nothing to gain by rejecting the settlement.
Nancy M. Royer, 56, of San Diego had to promise not to discuss her case or the amount of her settlement in order to receive the money, said her attorney, Samuel Hornreich of El Cajon.
Royer had a slightly abnormal Pap smear in 1988 and her doctor advised her to wait a few months and have another test, Hornreich said. That test came back negative from Central Pathology, but almost a year later she was found to have cancer, which by then had spread to her lymph nodes.
