The Cancer She Never Had, the Organs She Lost -By Fransiscus Nanga Roka

The medical injury is capable of being quantified with a $35 million verdict. It cannot bring back the organs that Isis Spencer lost. Her case raises the heartbreaking issue: What good is a second opinion if evidence opposing surgery cannot stop it?

In November 2025, a Philadelphia jury awarded Spencer $35 million when hospital staff performed an unnecessary hysterectomy after erroneously diagnosing Spencer with cancer. Eleven percent of the liability $12.25 million was apportioned to Penn Medicine and physician Janos Tanyi. In 2022, Main Line Health had settled for an undisclosed amount. Penn challenged the verdict and defended its physician’s reliance on external pathology and plans to appeal it. It should not be found therefore like a maxed out payment, or a judgement that is not easy to contest.

Spencer, 45, a mother of three had endometrial cancer diagnosed at Lankenau Medical Center. The previous complaint described biopsy slides that were contaminated and retesting at Penn that failed to confirm malignancy. She said Tanyi refused to investigate the inconclusive results and insisted that her only hope of survival was an urgent operation. The hysterectomy also involved removing both ovaries and fallopian tubes on March 8, 2021. Titled, “Personal Experience”, the complaint describes the devastating physical and cognitive effects of surgical menopause.

At the heart of the scandal is a transition from a false-positive laboratory result to an irreversible procedure. For each follow-up, there should be room to challenge the diagnosis. In here, the second opinion neither prevented a patient being harmed by the first mistake.

This does not mean however that every negative test negates a positive finding. In the governance question, clinicians should be able to reconcile conflicting evidence, document their rationale and allow the patient to play a role before they proceed. Investigating and disclosing uncertainty

The ethical implications runs deeper than the justeprice of a diagnosis; A patient is unable to weigh surgery in a meaningful way unless the information shared with her includes material bases to doubt the utility of performing it. A signature on any record does not prove that the decision was prudent.

This case should also not be used to call for non-targeted testing. Specific protections must be in place in those areas where diagnostic uncertainty collides with permanent loss of bodily function by the hospital.

Specifically, hospital boards should mandate an abstracted review of materially discrepant pathology in a peer-reviewed process before undertaking malignancy treatment. Findings should be reconciled by an independent pathologist and the treating clinician with documentation of specimen identity when indicated, and a record made of the justification for proceeding. There needs to be a clear, auditable exemption from no-fly for true emergencies.

Second, laboratories should increase total traceability of specimens tracing contamination and archiving slides and tissue. All suspected identity errors should trigger instant notification across all involved institutions.

Third, consent discussions need to clearly delineate between discordant findings, lingering uncertainty, viable options and the implication of postponement. Accessible copies of reports for the patients and early access to independent review.

Fourth, agencies such as regulators and accreditors should look into how hospitals deal with the disagreements regarding diagnostic matters. Also for the Board: Tracking Pending Discrepancies and Remedial Action There should never be a financial settlement that supersedes institutional learning.

Finally, patients who have been harmed require ongoing physical and psychological treatment in addition to compensation.

The international lesson, if a brutal one, is this: major institutions can still flounder at the most basic task of all asking questions about a diagnosis before acting on it. Authority must answer to evidence when it comes to safety.

This should prompt hospitals to deal with a harsh reality regarding Spencer’s case when no one has the responsibility and obligation to remove uncertainty, it falls on the patient and lives with them forever.

Fransiscus Nanga Roka

Faculty of Law University 17 August 1945 Surabaya and Managing Partner Law Firm Victorious Indonesia