A Portland jury found a radiologist negligent after a suspicious lung mass went unreported on earlier breast MRI scans. The 51-year-old patient later died from lung cancer.
A Portland, Oregon, jury awarded $7.8 million to the family of Wendi Lui, a 51-year-old woman who died from lung cancer after a suspicious mass appeared on medical scans years before her diagnosis. The verdict followed an 11-day medical malpractice trial in Multnomah County Circuit Court. Jurors determined that a radiologist’s negligence contributed to Lui’s death after abnormalities visible on earlier breast MRI examinations were not reported as suspicious.
Lui was an active woman who had never smoked and had participated in demanding open-water swimming events. She worked as a pastry chef and graphic designer and completed the Portland Bridge Swim, an approximately 11-mile event passing beneath the city’s bridges. Her diagnosis was particularly devastating because she had maintained an active lifestyle and had no history of smoking.
The case focused on breast MRI examinations performed at Legacy Good Samaritan Medical Center in Northwest Portland beginning in 2018. Although the scans were intended to evaluate breast cancer risk, they also captured part of her lungs. Attorneys representing her estate argued that a suspicious growth should have been identified much earlier, potentially allowing treatment before the disease spread.
A Lung Mass Appeared on Earlier MRI Scans
Lui underwent her first breast MRI in 2018 because she had dense breast tissue and a family history of breast cancer. These factors can make additional breast imaging appropriate when doctors evaluate a patient’s cancer risk. The examination unexpectedly captured an abnormality in one of her lungs.
According to information presented by her estate’s attorneys, the 2018 MRI showed a mass measuring approximately one centimeter. By the following year, the growth had reached about two centimeters. Despite that increase, the abnormality was not identified as suspicious until another examination in 2020.
By the time doctors recognized the concerning growth, its volume had increased substantially. Surgery was performed, but doctors discovered that cancer had already spread to four lymph nodes. Lui was diagnosed with advanced non-small cell lung cancer, a broad category that accounts for most lung cancer diagnoses.
The missed opportunity to investigate the abnormality became central to the family’s malpractice lawsuit. Attorneys argued that identifying the growth earlier could have changed the course of Lui’s treatment and improved her prospects. The jury ultimately agreed that negligence had contributed to her death.
Jury Finds Radiologist Negligent
The lawsuit named radiologist Dr. Kari Thomas, Diagnostic Imaging NW and Legacy Health in connection with Lui’s medical care. Thomas was employed by Diagnostic Imaging NW and worked in the imaging services associated with Legacy Good Samaritan Medical Center. The dispute centered on whether the radiologist had properly evaluated the medical images and recognized the abnormality.
Lawyers representing Lui’s estate argued that radiologists must examine all clinically relevant portions of an image, including unexpected findings outside the main area being studied. Although Lui’s examinations were ordered to screen for breast cancer, the images also showed a portion of her lungs. The family’s attorneys maintained that the visible growth required attention and further investigation.
The defense disputed responsibility for the outcome. The jury nevertheless found Thomas negligent and determined that the negligence caused Lui’s death. After hearing evidence during the 11-day trial, jurors awarded the family $7.8 million.
The verdict represents a substantial financial judgment in a case involving delayed cancer detection. It also illustrates the legal questions that can arise when an abnormality is visible during imaging performed for an unrelated medical purpose. A finding of negligence depends on the evidence in the individual case, rather than simply whether a diagnosis was delayed.
Husband Pursued Accountability After Wife’s Death
Lui’s husband, Gene Lui, pursued the legal case following her death. He had a professional background in psychiatry and had worked within the Legacy Health system, giving him familiarity with healthcare practices and medical institutions.
According to the family’s attorneys, Gene Lui declined settlement offers because he wanted the circumstances surrounding his wife’s care to become public. Accepting a private settlement could have ended the dispute without a trial. Instead, he continued pursuing the case until a jury heard the evidence.
The litigation brought attention to a medical mistake that the family believed had serious consequences for Wendi Lui’s survival. It also placed the conduct of the radiologist under examination in a public courtroom. The jury’s decision provided a legal determination of negligence, although financial compensation cannot reverse the family’s loss.
Lung Cancer Can Develop in People Who Never Smoked
Lui’s medical history also draws attention to lung cancer among people who have never used cigarettes. Smoking remains the leading risk factor for the disease, but it is not the only cause. People without a smoking history can develop lung cancer because of environmental exposures, genetic changes or other factors that are not always identifiable.
The Centers for Disease Control and Prevention estimates that approximately 10% to 20% of lung cancers in the United States occur among people who have never smoked. That represents roughly 20,000 to 40,000 cases annually. Possible contributing factors include secondhand smoke, radon exposure, air pollution and asbestos.
Research has also found important differences between lung cancer patients based on smoking history. A study published in JAMA Oncology, using cancer registry information from seven states, found that 15.7% of women diagnosed with lung cancer had never smoked. The corresponding figure among men was 9.6%.
The study included more than 129,000 patients diagnosed between 2011 and 2016. Researchers found that lung cancer among people who had never smoked was more common in women than men within the population studied. These findings help explain why a lack of smoking history does not eliminate the possibility of the disease.
Early Detection Remains an Important Challenge
Lung cancer can be difficult to recognize in its early stages because patients may experience few symptoms. Some people do not develop noticeable warning signs until the disease has progressed. When symptoms appear, they can include a persistent cough, chest pain, shortness of breath or coughing up blood.
Current federal screening recommendations primarily focus on adults with substantial smoking histories. Annual low-dose CT screening is recommended for certain adults ages 50 to 80 who currently smoke or quit within the previous 15 years and meet specific smoking-exposure requirements. Routine lung cancer screening is not generally recommended for people who have never smoked.
That distinction is important in Lui’s case because her lung abnormality appeared incidentally during breast imaging rather than a dedicated lung cancer screening examination. The legal dispute concerned the interpretation of images already obtained, not whether she should have received routine lung cancer screening.
Medical professionals must assess unexpected findings in the context of the examination and the patient’s circumstances. Not every abnormality is cancerous, and additional testing can sometimes create unnecessary risks. However, suspicious findings may require further evaluation, particularly when changes become apparent across successive scans.
For Lui’s family, the central issue was the time that passed between the first visible abnormality and the eventual diagnosis. The jury determined that negligence during that period contributed to her death. Its $7.8 million award leaves the case as a significant example of the consequences that can follow when potentially serious findings on medical images are not recognized promptly.
IMAGE: Author The Medical Futurist editors. CC4