Some radiologists and primary care physicians vehemently opposed this provision, arguing that it would disrupt the traditional doctor-patient relationship and place the radiologist in a position where the radiologist was ill-prepared. None of these potential adversities materialized, and within months, the MQSA`s provisions were quietly implemented without controversy. Not only has patient care been improved, but medical malpractice litigation alleging a lack of communication in breast cancer cases has virtually disappeared. Decision This matter was settled on behalf of the radiologist. The hospital and the family doctor also settled their cases. The outcome of the proceedings against the emergency doctors is unknown. A review of the cases described at the beginning of this article shows that, in many cases, the attending physician and the radiologist become co-defendants in malpractice lawsuits alleging a delay in diagnosis due to a miscommunication. Obviously, communication is a 2-way path. When these lawsuits are finally heard by a jury or are attempted to reach a settlement, the question of the relative liability of each of the co-defendants is discussed. In these cases, there is often a dispute between the communicator (radiologist) and the communicator (attending physician): the former argues that meaningful communication was transmitted, and the latter argues that the communication was never received. In some cases, radiologists state that even though they did not verbally communicate the results of the radiological examination, a written report was still sent and should have sufficed. If the appointing physicians did not notice or read the report because of inefficiencies in their practice, shouldn`t the radiologist be blameless? In theory, the radiologist should be protected because the EAC practice guideline for the communication of diagnostic imaging results states that “the attending physician or other relevant health care provider is also responsible for obtaining the results of the imaging studies he or she has commissioned.” 15 Many malpractice lawsuits in radiology are directed not against radiologists, but against radiology technicians. Below are examples of settlement amounts and jury damages in cases of radiological negligence against the technician.
Below are some jury and settlement amounts for malpractice claims against radiologists. These examples of misconduct in radiology are very helpful in understanding the settlement values of these claims. Unsuccessful communication lawsuits are not uncommon. The most common cause of medical malpractice litigation in the U.S. is “non-diagnosis,” but data from medical malpractice insurance companies show that the second most common cause is failure to report radiological test results.3 In fact, data show that communication problems are at least a causal factor in up to 80% of medical malpractice cases. This is not surprising considering that a survey of primary care physicians found that communication errors accounted for 70% of all errors in the field, surpassing diagnostic errors, which accounted for 47%.4 Another study found that physicians did not recognize 36% of abnormal radiological findings; Of these, many of which indicated possible cancer, were lost for follow-up.5 Three days later, the accused radiologist interpreted the study and noticed an area of slight blurred density in the left lung with fibrotic changes nearby. Differential diagnoses were a small developing mass or a small mass and a CT scan was recommended. This radiology report was sent to the emergency room, but there is no evidence that the emergency department forwarded it to the primary care physician. A note in the patient`s emergency medical record, dated the day after the emergency department visit, indicated knowledge of the assessment.
The entry indicated that lung function, oxygen saturation and chest x-ray were “OK”. The entry also included comments about the patient`s anxiety, a prescription for alprazolam, and the fact that the patient had been advised to see her physician in two days. The patient was seen by the family physician six days later. She reported better breathing and decreased anxiety. The medical evaluation showed that the patient`s asthma had improved and again listed high blood pressure, rhinitis, diamond deafness, dyspepsia and anxiety. The CAB publishes practice guidelines and technical standards annually. Because of their primacy, EAC guidelines and standards are extremely authoritative from a legal perspective. Despite the fact that the CAB explicitly states in its printed materials that its policies do not represent or reflect the standard of care, these policies and standards still have a major impact on the courts. The Arizona Supreme Court has stated how the judiciary views the CAB guidelines:13 The most common type of error is probably a perceptual error: the abnormality is present on the X-ray or CT scan, but the radiologist does not see it for some reason. It should be noted that a disproportionate number of medical errors are filed against radiologists versus radiologists who review a relatively small number of tests. Not surprisingly, this suggests that the less frequently a doctor checks a particular type of test, the more likely it is that they won`t detect an abnormality they should have seen.
Most radiological malpractice in the U.S. — about four out of five — results in an agreement for the injured patient. The rest go to court, and about half of them lead to a verdict for the patient. Why are radiological processing errors likely? The damage is often serious and the radiologist`s fault is often easy to identify. Depending on the nature of the problem, the delayed or missed diagnosis may have been medical malpractice and may have cost valuable treatment time or rendered a treatable problem incurable. How do these serious radiological defects occur and what are your recourses if you have been a victim of them? Delayed or missed diagnoses were the main reason for these complaints, cited by 64% of respondents, followed by treatment complications (14%) and poor outcomes or disease progression (12%). About 60% of radiologists said they were “very surprised” by the trial, higher than the GP`s 54% response rate. Another 32% were “somewhat surprised” to be brought to justice, while 9% were not at all. Lyman said members of the specialty are often surprised to perform their duties, but another provider may have missed the next step in the grooming process. In about 58% of cases, the rads were one of the many named parties in the lawsuit, compared to 13% when they were the only defendants.
In Ohio, a 70-year-old woman was hospitalized overnight with severe headaches. A non-contrast head scanner was interpreted as usual by an external radiologist employed by a teleradiology company. The next morning, the hospital radiologist gave a formal interpretation that concluded: “. Probably a normal CT scan, but due to questionable density in the anterior cerebral artery region, a CT scan with infusion is recommended. The radiologist made no effort to share the results directly with an emergency physician. Fifteen months later, the patient was admitted to the same hospital after collapsing at home. CT studies have shown bleeding, a rupture of the anterior cerebral artery aneurysm. The patient died 1 hour later. A malpractice lawsuit was filed against the radiologist, the emergency physician and the hospital.
Eventually, an agreement was negotiated, the terms of which were not published. A third mistake that has nothing to do with the diagnosis is the medication error.