A Canadian man’s family is sharing a disturbing story, in which multiple healthcare facilities failed to appropriately diagnose and treat his stomach pain. Only later, when treatment would no longer aide him, was the man correctly diagnosed with stage 4 cancer (terminal). Though all healthcare services involved in this case are highly respected within Canada, loved ones are asking for a hard review of diagnostic procedures and an investigation into why misdiagnoses occur. (1)

Just Constipation?

Searing stomach pain first brought Karel Pekarek into his local emergency department (Vancouver, B.C.) in July of 2019. Labs were drawn and an x-ray was taken of Karel’s abdomen. Emergency doctors diagnosed him with constipation, provided him with a prescription for laxatives, and asked him to follow-up with his family doctor.

Karel took their instructions and headed home for some much-needed rest. However, within five days his pain resurged, and he sought out emergency assistance in a nearby town’s hospital (New Westminster, B.C.). Despite more testing, this new emergency team arrived at the same diagnosis of constipation. Again, Karel went home thinking his pain was benign and would resolve soon.

Sadly, Karel made a third and final trip to an emergency department with his ravaging stomach pain, and newly onset vomiting. There he had laparoscopic surgery and was told his stomach pain was in fact much more than constipation. He had terminal stage 4 cancer, which was slowly taking over his gall bladder and liver. The time for treatment had passed, and Karel was only given only months to live. Karel’s daughter, Katharina Andrews, told Canadian media outlets, “There’s just a lot of regret … that they kind of didn’t catch it when he had gone for help, finally. It was way, way too late.” (1)

Diagnostic Challenges Ongoing

In Canada, an estimated 10% – 15% of medical cases result in a misdiagnosis say experts in the field of physician-cognition. Although there is no public reporting system for medical errors, research and improvements in medical education are ongoing from an academic standpoint. For example, Dr. Pat Croskerry of Dalhousie University has dedicated his life to increasing awareness of diagnostic error among current and future generations of physicians. To Croskerry, skills like reflection, critical thinking, environmental scans, and ongoing patient reassessment are considered crucial to the prevention of physician error. (2)

Patient Safety First

Life after a diagnostic error for Karel Pakarek was agonizing for his family. Not only is his family haunted by a potential loss of life-saving treatment due to his late diagnosis, but also a lack of symptom and pain control in his final months of life. Karel could not keep down any food and was only offered Tylenol by healthcare professionals for pain when he entered palliative care. Moving forward, both of the overseeing health authorities involved with Karel’s case have offered their condolences to the Pakerek family and promise to launch safety reviews into why his condition was repeatedly missed. The Pakareks hope this review helps other, especially in Canada, who need healthcare services and better symptom management. (1)

For you, whether your a patient or a loved one, help stop medical error by being a strong medical advocate. Keep detailed medical records, including a journal of signs, symptoms, and related events. Keep in tune with your healthcare team’s plan, anticipating testing, transfers, and discharges from medical facilities. Thoroughly read and understand consent forms of all types, ask questions, and ensure your medical team knows what medications you have been taking at home. (3) This seems like a lot (I realize!), but nothing is more important than your health and the health of your family – so it’s worth protecting!