A Salt Lake woman who underwent a radical mastectomy after a doctor allegedly failed to diagnose her breast cancer has filed a lawsuit against the physician and Intermountain Health Care.

Darla Ray Koch, 48, first detected a marble-size lump in her left breast in July 1995 during a self-exam. She watched it for a few months and called the mammography department at Cottonwood Hospital when the lump didn't go away.Following hospital policy, a secretary scheduled Koch for a diagnostic mammography a week later. But when the woman arrived for her appointment, the radiology technician on duty performed only a screening mammogram, according to the lawsuit filed in 3rd District Court.

A screening mammogram is not as thorough as a diagnostic mammogram, which can include a needle biopsy of a suspicious lump.

"It was at the end of (the technician's) shift and we think she just got in a hurry to go home," said James D. Vilos, Koch's attorney.

The technician also failed to perform or have a physician perform a clinical exam of Koch and did not order an ultrasound, though the worker acknowledged Koch had reported a suspicious lump, the lawsuit states.

To compound problems, an attending radiologist, Dr. Richard H. Keller, misread the screening mammogram the following Monday, missing the lump, Vilos said.

Despite that, he still should have been more diligent in ruling out the possibility of breast cancer because Koch had reported the presence of a suspicious lump, the lawsuit states.

"He misdiagnosed (Koch's) condition as normal without first ruling out the possibility of breast cancer. He negligently ignored Darla's admitting diagnosis which disclosed a cardinal sign of breast cancer," the lawsuit states.

The doctor told Koch's regular physician that everything was OK, so Koch went on with her busy life, Vilos said.

Eight months later, Koch attended a Utah Cancer Control program at her church at which workers conducted a clinical exam and discovered the lump had grown to the size of a walnut. They referred her to St. Mark's Hospital.

Doctors there performed a diagnostic exam, which revealed a cancerous 11/2-inch lump. Surgeons also removed 15 lymph nodes, eight of which were positive for cancer, the lawsuit states.

"Had the cancer been diagnosed in September of 1995, Darla would simply have required removal of the cancerous lump." Instead, Koch has had her left breast and some muscle in her left arm removed and underwent painful chemotherapy and radiation therapy, Vilos said.

The lawsuit does not ask for specific damages.

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IHC spokesman Jess Gomez said the hospital sympathizes with Koch. "However, we believe appropriate care was delivered," he said.

The lawsuit is the second of its kind now proceeding through Utah courts. The state Supreme Court this summer cleared the way for a jury to hear the case of Beverley Ann Seale, who died after a doctor at Holy Cross Hospital failed to diagnose her breast cancer.

Dr. Donald F. Gowans reviewed her mammogram but overlooked a small mass in her left breast, according to previous court testimony.

Hearing dates have not yet been set in either case.

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