The opinion of the court was delivered by: MARSH
This action arises under the Federal Tort Claims Act, 28 U.S.C. §§ 1346(b), 2674. Plaintiff, Alice Jean Chester, Executrix of the Estate of William Chester, deceased, is a citizen of Pennsylvania and a resident of Pittsburgh. At all times relevant hereto, the defendant, through the Veteran's Administration, operated the Oakland Veteran's Administration Hospital in Pittsburgh (hereinafter called the Hospital).
William Chester died of advanced gastric carcinoma on October 8, 1973 at the age of 49; he is survived by his widow, Alice Jean Chester, aged 50 at the time of trial, and 11 children: Carol Lamb, 27; Kevin 25; Mary Beth, 21; William, 19; James, 19; Janet, 17; Patricia, 15; Michael, 13; Jeane, 12; Margaret, 10; Rachel, 8. The widow and 10 children lived at their home in Pittsburgh at the time of decedent's death. At the time of trial five children were under 18.
Since the decedent was discharged from military service he had been treated by Government Hospitals on various occasions for service connected conditions. In 1946 an infected hypoplastic kidney was removed, and since then he had been afflicted with hypertension.
In January, 1971, he reported to the Hospital that he had blurred vision, angina pains in his chest of six or seven months duration, constant bitemporal headaches, dizziness, pain in his eyes and "general tiredness." He reported that his father had died of a heart attack and his mother had died of carcinoma of the esophagus. No diagnosis was made, but he was treated for hypertension on an outpatient basis, generally visiting the hospital monthly. He was obese, weighing 239 pounds. He was a heavy cigarette smoker. Altogether from December, 1970 to March 12, 1973, he visited the Hospital approximately 20 times.
From January, 1971 until about June, 1972, his hypertension seemed to be under control and he worked regularly at his position as a supervisor -- investigator for Wackenhut Corporation.
As early as June 12, 1972 he was exhibiting symptoms consistent with carcinoma of the esophagus. From June on he experienced a steady decline in health. He weight 232 pounds, he had very high cholesterol, he complained of loss of energy, fatigue, decreasing exercise tolerance, suffered pain intermittently under his rib on his left side which radiated into his left arm, his liver was enlarged, and his appearance changed radically. In August his pains were more frequent and severe, he could not swallow well and regurgitated several times a week, he experienced pain on swallowing and pain on eating. His eating habits changed; from being a hearty, fast eater he changed to eating slowly, eating soft foods and drinking liquids to get the food down; he became pale and lost considerable weight.
Mr. Chester complained frequently in July and August to his wife and to the doctors in the hospital about his pains and difficulty in swallowing. His wife, a registered nurse, who was employed by the Hospital, also complained to a doctor in the Hospital about her husband's unrelieved pains and swallowing difficulties.
In view of these urgent complaints of Mr. Chester and his wife disclosing symptoms consistent with cancer of the esophagus, the doctors in the Hospital were negligent, and through them the Government, in not ordering an esophagoscopy, upper gastrointestinal x-rays, an esophagram, biopsy and a barium swallowing test to rule out a diagnosis of cancer of the esophagus.
Unable to get relief at the Hospital, Mr. Chester, probably in desperation, related his complaints to Dr. Dornenberg, a surgeon in private practice, who was known to the Chester family. Dr. Dornenberg immediately sent him to the Pittsburgh Hospital for upper gastrointestinal x-rays. The x-rays were taken on November 3, 1972. Dr. Dornenberg read the radiologist's report to Mr. Chester. Upon the next visit to the Hospital on November 27th Mr. Chester reported to Dr. Harbans Singh at the Renal Clinic that the Pittsburgh Hospital x-rays disclosed that he had a hiatus hernia. Actually the x-rays clearly demonstrated an obstruction of the cardio-esophageal junction to a degree indicative of carcinoma of the esophagus.
I find that Dr. Singh was mistaken when he stated that Mr. Chester told him he was taking treatments from Dr. Dornenberg for his hiatal hernia, or treatments from any family doctor. Mr. Chester was not treated by Dr. Dornenberg, nor did he consult the radiologist, Dr. Kwang Choi, nor was he treated by any private family doctor.