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The Virginia Board of medicine has recommended Dr. Alan Joshua for his failure to order appropriate testing for a patient who complained of rectal bleeding. The Board of medicine found that Dr. Joshua had violated during his treatment of the patient from 2001 to 2003.
According to the disciplinary order "despite the patient's history, symptoms, and a finding of atypical cells during a urine cytology taken in October 2004, Dr. Chavez failed during this period to order appropriate diagnostic tests to determine the cause of the patient's hematuria." In December 2006 Patient A was found to have high-grade muscle-invasive urothelial carcinoma, a highly aggressive cancer with a very bad prognosis.