For more than 3 ½ years, Eliza Butler’s medical team failed to diagnose her breast cancer, and by the time doctors at a different hospital caught it the cancer had metastasized, a lawsuit alleges.
Butler’s husband, Wade, is suing St. Joseph Hospital and Healthcare alleging medical malpractice, claiming that they caused Butler’s wrongful death and failed to provide acceptable medical care, according to a lawsuit filed in Penobscot County Superior Court.
The couple owned longtime Bangor candy shop, Specialty Sweets, which closed in 2019. They had four children, ages 13 and younger.
Butler died Jan. 1, 2023, at 42 years old, about 16 months after she was diagnosed with Stage IV breast cancer called lymphangitic carcinomatosis. Four masses were found July 14, 2021, after a mammogram was performed at Northern Light Eastern Maine Medical Center, the lawsuit said.
During the years before Butler was diagnosed, she had numerous visits to St. Joseph hospital with different providers where she described vision loss, back pain, a tingling arm, problems breathing and more issues, according to the lawsuit.
No mammograms or ultrasounds were ordered during those years, and a full breast exam was not performed at St. Joseph. Butler’s cancer was diagnosed after she was admitted to EMMC in July 2021, the lawsuit said.
St. Joseph is negligent in Butler’s death because the hospital is in charge of doctors, nurses and other staff who failed to provide reasonable care, the lawsuit said. In the earlier stages of Butler’s cancer, she was more than likely to survive, with up to an 82 percent survival rate with various medical interventions.
The lawsuit is asking for all damages that would have been allowed prior to Butler’s death because she suffered harm while alive that was a result of St. Joseph’s negligence. The lawsuit is also asking for all damages allowed through Maine’s death act.
The hospital does not comment on pending litigation, Communications Manager Amanda Millay said.
After finding a “cord” in her left armpit, Butler called her primary care doctor, Jennifer Freese, and had an appointment Dec. 5, 2017, with nurse practitioner Christine Nealley. The area was tender to the touch and breast cancer was a possible diagnosis Nealley said, the lawsuit said.
Next steps should have included an ultrasound and mammogram, which Butler asked to be delayed until January because the time of year was busy, the lawsuit said. Freese should have followed up with Butler to order the tests, but the issue was not brought up “for another 3 ½ years.”
No other breast or axillary examinations were performed during the following years, despite Butler continuing to report pain, per the lawsuit. At an appointment Jan. 2, 2019, she told Freese her arm had been hurting for a few months and the pain never really went away.
During a deposition, Freese said typical standard of care requires a breast exam and imaging if a patient has pain in that area. However, she did not do an examination of the area for Butler, and did not even have her remove her shirt to visually look at the area, the lawsuit said.
Freese was required to review Butler’s medical records, which would have referenced the mammogram she was supposed to have in late 2017 and would have known it was to rule out breast cancer. She never knew Butler had reported a mass in December 2017, per the lawsuit.
In August 2020, Butler again reported pain and issues with her left arm, including a lack of feeling on the back of it. She had an appointment with Freese, who did not examine the area because “it seemed more musculoskeletal,” Freese said in a deposition.
Freese left St. Joseph in February 2021 for a new job and Butler’s care was transferred to physician assistant Dennis Scott Simpson. The lawsuit said Butler reported back pain to Simpson, but he had not reviewed her medical records and did not perform a breast exam.
She was referred for osteopathic manipulation therapy and returned to the hospital with back pain again in late February. Simpson noted a lump in Butler’s left armpit, which was the first time anyone at the hospital had examined the area since December 2017. No imaging was ordered and Simpson did not do a complete breast exam, per the lawsuit.
By April 2021, Butler had vision disturbance in her left eye, severe headaches and tingling in her left arm. She was also being treated for anxiety, and had fatigue and back tightness. An MRI on her shoulder showed some excess fluid, while MRIs on her cervical spine and brain were mostly normal.
On June 8, 2021, Butler went to urgent care because she had been having difficulty breathing for weeks and was given an inhaler. She went to St. Joseph on June 9 because of her shortness of breath, continuing back pain and anxiety. She was “educated on the use of the inhaler” and was prescribed a corticosteroid, the lawsuit said.
Butler went to the EMMC emergency room on June 13, 2021, at the recommendation of the urgent care. According to the lawsuit, a CT of her chest had “several abnormal findings.”
An exam from Simpson on June 16, 2021, was “exactly the same” as the February exam, he said during the deposition. A pulmonologist reviewed Butler’s CT and said cancer was a possible diagnosis.
During an ultrasound June 29, 2021, Butler said she had been coughing up blood for a week. She then said she had rapid heart rate and low oxygen saturation on July 1. Four nodules were found during a mammogram on July 6, 2021, at St. Joseph.
Butler went to the emergency room at EMMC on July 11 because her shortness of breath was worse. The hospital told her to return the next day to be admitted, per the lawsuit. Biopsies and a bronchoscopy were performed July 14, 2021, which showed Butler had metastatic breast cancer.
Her shortness of breath was likely related to the cancer spreading, Cancer Care of Maine doctors told Butler. Antibiotics did not help improve her breathing, the lawsuit said.
Butler tried multiple chemotherapy drugs, with the knowledge that the treatment was for palliative care to delay progression of the cancer, not to provide a cure.
A September 2021 bone scan at Cancer Care of Maine showed multiple metastases throughout Butler’s body. A new chemotherapy drug resulted in significant reduction to the disease in August 2022, the lawsuit said.
Butler had a break in treatment during late November and December 2022. During that time, Butler developed a fever and suspected pneumonia and was hospitalized. She was discharged Dec. 10 and then returned to the hospital Dec. 11 to 16.
On Dec. 30, a Cancer Care of Maine doctor explained to Butler that she would have a very low probability of recovery if she was placed on a ventilator because her cancer treatment could not continue. Butler was pronounced dead at 9:32 a.m. on Jan. 1, 2023.
