Nurse practitioner missed a fatal diagnosis

Originally posted on Reddit

Let me preface by saying, this happened to a very close family member of mine. I don't know all of the details 100 percent because most of what I know is what I heard through her.

She was a long-time smoker with a history of lung cancer that had been treated with radiation a few years back. She had been in remission since that time. She mentioned to us one day that she had started experiencing some pretty severe shoulder pain. At the time, none of us thought much of it. She saw her "doctor" (which we only later found out was an NP) and was told it was arthritis. However, things only progressively got worse. She started having severe weakness in that arm. The pain kept getting worse and was now radiating to her back. She saw the same NP again and was once again told that it was arthritis. It continued to get worse and worse. It got to the point that she started having multiple falls because her legs were now extremely weak. She went back to the same NP who STILL said it was caused by arthritis and advised her to use a walker to avoid falls (mind you, this is a 50-year-old woman). She never once got ANY imaging or workup other than a shoulder x-ray at the first visit.

It was shortly after this visit with the NP that I saw her again in person for the first time in a long time, and she looked terrible. She had lost a ton of weight, could barely move due to weakness, and was exhausted just from talking. So, I decided to take her to the ER. Yes, I know now probably this was not the best use of the ER but I just didn't know what to do. It was so shocking to see her like that. She described her symptoms to the ER MD who immediately ordered a CT of her spine. And lo and behold...there was a MASSIVE tumor.

They tried to start chemo right away and were planning surgery to debulk, but by the time the tumor was found, it was too late. She was completely paralyzed within two days of diagnosis and then was gone within one week.

I can't help but feel extreme guilt now looking back. I wish I had known that she was seeing an NP and not an MD/DO. I would've asked so many more questions. I wish I had known how much of a red flag her symptoms were. Back then, I was only a pre-med and had no idea about the severity of the situation. I trusted that she was getting the care she needed from her "doctor". But it kills me. I feel so much guilt.