Lindsay Sightler visited Dr. Ashley Lubecki, her OB-GYN, in September 2018 to confirm her pregnancy and because she “was concerned about a small mass . . . on the left side of [her] breast.” Dr. Lubecki “took a quick history” and referred Sightler for an ultrasound due to “a left palpable abnormality.” She did not physically examine Sightler’s breast, and she referred Sightler for the ultrasound based solely on Sightler’s assertion that she felt a mass.
Dr. Stafford Brown performed the ultrasound on September 27, 2018, and interpreted the results. He “didn’t see a mass” or anything else concerning on the ultrasound. He instructed Sightler to follow up “if it doesn’t change, if it increases in size,” or after her pregnancy. Four months later, in January 2019, Sightler followed up and called Dr. Lubecki. She asked for another ultrasound, but Dr. Lubecki declined to order one, as she believed it was too soon. After Sightler gave birth to twins, she again requested an ultrasound. Dr. Lubecki ordered a second ultrasound.
Dr. Andrew Zasada performed the second ultrasound in September 2019. He found that the ultrasound showed “areas of heterogeneous echogenicity at the palpable areas at 7 and 4:00.” Dr. Zasada thought the palpable masses on Sightler’s breast were “consistent with galactoceles,” which is “a mass that results from a blocked” milk duct. He advised her to follow up with her physician if the lumps did not go away.
In January 2020, Sightler went to Dr. Lubecki for her annual OB-GYN appointment. Sightler described the mass in her breast to Dr. Lubecki, and Dr. Lubecki performed a breast exam, finding two masses. Dr. Lubecki ordered another ultrasound. At that ultrasound, the radiologist also performed a “diagnostic mammogram” and recommended that Sightler be referred for a biopsy due to the concerning results of the mammogram. Dr. Lubecki referred Sightler to a breast surgeon for a biopsy, and Sightler was diagnosed with invasive ductal carcinoma in her left breast, which had also spread to her lymph nodes.
Sightler consulted an oncologist and surgeon, who recommended a mastectomy. She was not a candidate for a lesser invasive lumpectomy given the stage of her cancer. Sightler underwent treatment, first with the mastectomy and axillary lymph node dissection to remove some of her lymph nodes. After healing from surgery, she continued with chemotherapy, radiation therapy, and hormonal therapy. She also elected for subsequent breast reconstruction.
Sightler filed a medical malpractice suit against Dr. Lubecki, Dr. Brown, Dr. Zasada, and their respective employers. Sightler claimed that both Dr. Brown and Dr. Zasada had misread her ultrasounds in September 2018 and September 2019, respectively. She alleged that if they had read the ultrasounds correctly, her cancer could have been diagnosed earlier, leading to less invasive treatment and a lower risk of recurrence.
At the end of the Virginia medical malpractice trial, the jury awarded Sightler $98,000 in damages against Dr. Lubecki
and Bayview. The jury found in favor of Dr. Brown and Hampton Roads Radiology Associates, P.C. Thus, the circuit court entered a partial final judgment order entering judgment for Dr. Brown, Dr. Zasada, and Hampton Roads Radiology Associates, P.C. Sightler appealed.
The Court of Appeals of Virginia stated in its August 19, 2025 unpublished Memorandum Opinion: “Whether the standard of care required Dr. Brown to order a mammogram was not at issue because Sightler was prohibited from eliciting that testimony from her expert after failing to include it in her expert designation. Further, Sightler argues, both below and on brief, that she was attempting to impeach Dr. Katzen’s “testimony that Dr. Brown ‘did everything right’ in the interpretation of the 2018 ultrasound.” But the guidelines she sought to use to impeach Dr. Katzen did not deal with how to interpret the ultrasound, but rather what should have been done after the ultrasound was interpreted. Thus, the line of questioning was also not relevant to the challenged testimony.”
“Radiologist Dr. Rebecca Zuurbier also testified as an expert witness for Sightler. Dr. Zuurbier opined that Dr. Brown breached the standard of care in interpreting Sightler’s September 2018 ultrasound. Sightler attempted to elicit testimony from Dr. Zuurbier that Dr. Brown should have ordered a mammogram. Dr. Brown’s attorney objected, arguing that that opinion was not designated in the pre-trial expert designations. Counsel pointed out that Dr. Zuurbier’s expert designation indicated only that Dr. Brown “should have recommended an ultrasound guided core breast biopsy.””
“Here, the circuit court recognized the difficulty of expecting the jury to distinguish between using the guidelines to impeach Dr. Katzen’s credibility and using the guidelines to establish that the standard of care required Dr. Brown to order a mammogram. Nothing in the record establishes that the circuit court abused its discretion in limiting the cross-examination on this basis. Whether the standard of care required Dr. Brown to order a mammogram was not part of the case due to Sightler’s failure to properly include that issue in her expert designation. There was a real risk that the jury would consider the guidelines, which stated that a mammogram was required, in establishing the standard of care, which could “lure the factfinder into declaring guilt [or liability] on a ground different from proof specific” to the case.”
” … we affirm the judgment of the circuit court.”
Source Sightler v. Zasada, M.D., Record No. 2133-23-1.
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