From the story, it is evident that this gentleman has long been aware that he might develop myeloma. This implies that he had been diagnosed previously with a m

From the story, it is evident that this gentleman has long been aware that he might develop myeloma. This implies that he had been diagnosed previously with a monoclonal gammopathy of unknown significance (MGUS). This may be clinically suspected based on routine bloodwork showing a gamma gap. Once you suspect it, there is a fixed protocol for further investigation. It also sounds like there were lapses in the routine checkups that would help with early detection if this did progress to myeloma. Very unfortunate; this CEO seems like a delightful person and I wish him the best.