title: [Missed malignant melanoma: legal considerations].
abstract: Malignant melanoma may be missed both clinically and histopathologically. The appearance of metastases after local excision of a skin lesion which was not recognized as melanoma indicates a diagnostic error. In a lawsuit three things have to be proven: that the doctor has behaved negligently, that the patient has been damaged and that there is a causal relation between the two. After local excision of a lesion that subsequently proves to be a metastasized melanoma, no damage ('loss of chance') occurs because neither local surgery nor adjuvant therapy influences disease-free survival. These particularities are of importance in legal judgments.
authors.affiliation: Erasmus Universiteit Rotterdam, Rotterdam Institute of Private Law, The Netherlands. rwm.giard@xs4all.nl
authors.forename: Raimond W M
authors.initials: RW
authors.lastname: Giard
authors.forename: Jan M
authors.initials: JM
authors.lastname: Broekman
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003951:Diagnostic Errors / Q000331:legislation & jurisprudence*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008318:Malpractice; D008545:Melanoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D009426:Netherlands; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology