This case involves a forty-five-year-old female who was referred to a gastroenterologist with right upper quadrant abdominal pain and fatigue. Her past medical history included hepatitis B, diabetes mellitus, and twenty years of smoking. She could only speak Spanish and understood English poorly. She first contracted hepatitis fifteen years prior to the incident in question, but medical records did not show how she was treated. The physician believed that the woman’s hepatitis infection had reactivated and he treated her with an antiviral. Blood work was done, but the woman was never contacted with the results. She was given a sheet to have a CT scan but translation services were never used to communicate this information. Additionally, she was never scheduled for a follow-up appointment. Six months later, she went to the emergency room because she experienced bloating, diffuse bruising, weight loss, abdominal pain, and yellowing of her skin and eyes. A CT scan of the abdomen revealed a large mass on the liver. Laboratory testing showed that she had markedly elevated alpha-fetoprotein levels. The lesion was later biopsied and diagnosed to be stage III hepatocellular carcinoma, a form of liver cancer. She underwent a left hepatic lobectomy. She was placed on an organ transplant list but died before she received a liver.
