Durban - Just three days after being discharged from hospital after major surgery, cancer-stricken Durban advocate Rob Sichel shuffled into court to give evidence in his case against the dermatologist he accuses of misdiagnosing him two years ago.
Sichel, 52, said the dermatologist failed to recognise a malignant melanoma.
He now has stage-four cancer and, after being told in March that he had only weeks to live, he launched an urgent application for his evidence to be heard “on commission”, transcribed and preserved for eventual use in his multimillion-rand medical negligence case which, barring a miracle, will not be heard until after his death.
Walking on crutches and wearing a neck brace, Sichel – a former businessman who has been an advocate for six years after changing careers in his mid-forties – broke down as he told Durban High Court Judge Rashid Vahed how, in March, his oncologist said there was nothing more she could do.
“She said I must just go and enjoy my last few weeks. I asked her how long. She said six,” he said.
Sichel’s civil claim is against Glenwood dermatology practice Dylan Naidoo Incorporated and the dermatologist who treated him. Both are defending the claim, denying that Sichel’s condition was misdiagnosed or that the dermatologist prescribed that a lesion behind Sichel’s right ear be frozen off with liquid nitrogen.
They said Sichel refused treatment by storming out.
In his testimony, Sichel said he had a cancerous growth removed from his leg when he was just 13. Because of this, as an adult, he had been vigilant about any sun spots and had regularly visited dermatologists and his doctor.
His hairdresser had first seen the lesion and, with Dylan Naidoo not at work, he made an appointment to see the dermatologist on March 9, 2012.
She photographed the lesion and looked at an enlargement on a monitor.
“She went through the characteristics and indicated that it was a form of keratosis (sun spot), nothing to be concerned about, and should be frozen off,” he said.
When he went to the treatment room, he was told there was no liquid nitrogen. He admits that he got “quite irate” and accused the staff of lying to him and wasting his time.
He left and went straight to his GP, told him the diagnosis and told him to freeze it off.
“He seemed a bit dubious. But I persuaded him of the diagnosis and he did it,” Sichel said.
In November that year, a gland swelled in his neck and his doctor referred him to another dermatologist, Len Nel, who biopsied the lesion.
Two days later, Nel gave Sichel the bad news that he had a stage three malignant melanoma. After surgery, he was under the care of an oncologist and “clean” for a few months before a routine scan in August last year showed the cancer had spread.
Out of “compassion” a British drug company donated a 12-week course of Ipilimumab, an immunotherapy not yet available in South Africa, which ordinarily would have cost R4 million. But it did not work. Neither did a course of another drug which he sourced in the US.
When he went on a weekend cruise, he had a seizure on the ship and tests revealed that the cancer had spread to his brain.
He went to another oncologist, Rory Callaghan, and had subsequently had 20 sessions of radiation and an operation to remove some of the melanoma pressing on his spinal cord. He was expecting to have more radiation and chemotherapy.
Under cross-examination, Sichel conceded that in his claim he should not have included an amount of R4m for the Ipilimumab because it had been given to him free.
He also conceded that when he made the appointment he said he was coming in for “freezing for sun spots” and asked that staff make sure that liquid nitrogen was available.
In papers before the court, lawyers for the dermatologists said Sichel had made an appointment to deal with “existing solar keratosis”.
“He terminated the doctor/patient relationship on the same day without allowing the dermatologist to properly treat or investigate a small lesion noted incidentally during her examination.”
Sichel’s attorney, Michael Friedman, confirmed the evidence would be transcribed.
“I don’t know when the trial will happen. It could take anything up to a year.”