ST. PETE BEACH — The diagnosis Judy Karpinski feared came two days before Christmas.
She had been warned by her dermatologist in September 2021 that she could have a cancer in her lymphatic system that often spreads to other organs. On the Dec. 23 call, she was told further laboratory tests from UF Health had proven the diagnosis. The dermatologist told her how sorry she was.
“You’re sure I have cancer?” she remembers asking at least five times.
Her husband was inconsolable. Instead of celebrating Christmas and New Year, the couple fretted about her future. They canceled a $10,000 nonrefundable six-week vacation to Turks and Caicos.
For two months, the diagnosis weighed on Karpinski, 59, until she got new test results from the Moffitt Cancer Center. Not only was she cancer free, doctors there told her, but she did not need any treatment.
Her case highlights how Florida law rarely provides recourse for patients who feel they are victims of medical misdiagnoses or mistreatment — but have suffered no permanent harm. Malpractice lawsuits must be backed up by expensive experts, making attorneys reluctant to take on cases where there is little chance of winning substantial damages.
“What these hurdles have done is prevented people who have smaller wrongs from being able to be justly compensated,” said Betsey Herd, one of several attorneys that Karpinski approached who declined to take her case. “I’m not a lawyer who will take a case where I get paid, and the expert gets paid, but the clients get nothing.”
Karpinski said she believes the blame for her misdiagnosis lies with UF Health.
UF Health officials provided a statement but declined to comment on her specific case citing patient confidentiality. When told that Karpinski was willing to waive her right to privacy, they still declined to discuss her situation.
“We seek to provide high-quality care for every patient and a safe, secure environment for our doctors, nurses, staff, patients and their families, and visitors,” the statement reads.
Karpinski’s diagnosis was from a biopsy of two small lumps on her back and shoulder. The samples taken in September 2021 at a Bay Dermatology clinic in St. Pete Beach were not tested there but sent to UF Health, her medical records show. Her dermatologist relayed the results, telling Karpinski she had B-cell lymphoma, a fast spreading form of cancer common in older patients that is often treated through chemotherapy.
The dermatology clinic sent a referral for Karpinski to Moffitt where doctors drew 17 tubes of blood and performed new biopsies. However, Moffitt doctors determined Karpinski had T-cell lymphoproliferative disorder, a condition that most commonly affects the skin, causing rash-like patches, itching and sometimes even tumors. They sent her home with topical cream.
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Richard Miller, a doctor at Bay Dermatology, said the decision to refer Karpinski to Moffit was the correct one, given that her lab results presented a cancer risk.
”I do what I think is best for every patient,” Miller said. “I would want the same thing done for me that I did for her.”
Expecting expensive medical treatment, Karpinksi upgraded her medical insurance to a $1,400-a-month policy, $600 more than what she had been paying. As she had not met her deductible, she also had to pay Moffitt $4,250 for the tests and consultation.
In all, Karpinski estimates she is out of pocket more than $20,000. She called several attorneys but they all told her there was little point filing a lawsuit since she’s healthy and any damages would likely not cover the cost of going to court.
As in many states, Florida requires that a medical expert review the case and sign an affidavit attesting there is grounds for medical malpractice before a lawsuit can be filed. That typically involves hours of attorney time compiling treatment records, reviewing the case and obtaining the expert’s findings, said Herd, a Tampa attorney who has specialized in medical malpractice for 28 years.
Attorneys also discouraged Stephen LeCroy, a former St. Petersburg Fire Department captain, from filing a medical malpractice suit after he sought to challenge a $900 bill from BayCare Health System.
LeCroy, 64, spent three days at Morton Plant Hospital in January 2022 after being rushed by ambulance to the Clearwater hospital when he started having breathing difficulties. It happened about 18 hours after he had back surgery at another BayCare facility, Mease Countryside Hospital.
LeCroy was already taking Oxycodone, an opiate painkiller, to manage symptoms from his surgery, his wife told doctors. The drug was listed as one of his active medications, Morton Plant medical records show.
Doctors there said his respiratory troubles were bacterial pneumonia and gave him antibiotics through an IV. They also gave him Dilaudid, a powerful painkiller derived from morphine and a cough medicine that includes codeine.
Oxycodone is listed by the Mayo Clinic as one of the drugs that should not be combined with Dilaudid, although its guidance states that it “may be required in some cases.” Soon after he took it, LeCroy suffered an intense and distressing period of hallucinations during which he said faces emerged from walls and creatures crawled on the floor. His wife later told him he repeatedly pointed his camera phone at things he thought he was seeing.
The hallucinations lasted several days even after LeCroy was discharged, he said. His medical records show that doctors recorded the episode as acute delirium.
BayCare officials declined to comment on the case.
LeCroy hadn’t planned to take action until he received a $900 bill, his share of a nearly $46,000 charge the hospital billed his insurance. He is refusing to pay and it has since been sent to collections.
“I’m sure I would not have stayed three days,” he said. “I just don’t think I should pay for their negligence.”
LeCroy, who served as a paramedic for 35 years and is a qualified respiratory therapist, felt he had sufficient medical knowledge to challenge BayCare over the bill. He talked to three law firms, getting the same response: “They said, ‘If I would have died or had permanent injury then your family would have had something to sue for’,” he said.
In any other walk of life, LeCroy could file in small claims court, where plaintiffs can ask for up to $8,000 if they feel they have been wronged. But Florida does not allow that option for medical malpractice cases, said Jay Wolfson, a University of South Florida professor who teaches health care policy at Stetson University College of Law.
That means minor cases must go through the same medical malpractice process that is designed to prevent frivolous lawsuits. The cost of attorneys and medical experts needed to take a case to court can rise as high as $100,000, he said. In a case where the patient emerges from a medical ordeal uninjured, juries are unlikely to award significant damages, he said.
“Juries tend to say, ‘You’re OK now,’” he said. “That it was negligence or bad actions is very hard to prove.”
A doctor can lose their license if they have three malpractice judgments against them, Wolfson said. Other options for aggrieved patients include filing complaints with the Florida Medical Board or with the Florida Agency for Health Care Administration. Depending on the nature of the complaint or if those government agencies receive multiple reports, it can lead to an investigation and sanctions, Wolfson said.
“The patient likely won’t get money but can get a degree of moral satisfaction they have identified a problem with an institution,” he said.
LeCroy said he has filed complaints about his treatment with the Agency for Health Care Administration and the Joint Commission, an organization that accredits hospitals. The Times reviewed copies of the complaint. The Agency for Health Care Administration does not comment on specific cases.
Karpinski says she filed a complaint with a laboratory accreditation service run by the College of American Pathologists. The college did not respond to two emailed requests seeking comment.
She also reached out to UF Health, as she was concerned that the skin cancer diagnosis was still in her medical records.
At first, the institution declined to change its diagnosis but eventually agreed to have the National Cancer Institute review sample slides from the Moffitt biopsy. Cancer Institute doctors confirmed Moffitt’s diagnosis, medical records show.
After Karpinski asked the university to make up for the money she lost, the university offered to go into pre-suit mediation. Karpinski declined the offer when she realized that would mean waiving her right to sue and to talk about her case.
When told that Karpinski was willing to waive her confidentiality rights, officials still declined to comment.
Karpinski can still remember seeing cancer patients at Moffitt and fearing she would undergo a similar experience. She said there needs to be more accountability for doctors when patients experience such turmoil.
“I am grateful to be healthy,” she said. “But they’re turning their back on a false cancer diagnosis. This is not a splinter. This is a big deal.”