The Doctors Company, which is the largest medical malpractice insurer owned by physicians in the United States, has issued a report entitled “Diagnostic and Interventional Radiology Closed Claims Study” in which it reports on the findings of its analysis of 596 claims (written demands for payment) against radiologists that closed from 2013 through 2018. The study divided the medical malpractice claims against the radiologists into two subspecialty groups: diagnostic radiology claims (542) and interventional radiology claims (54).
The analysis found the three most common case types in diagnostic radiology claims made up 85 percent of those claims (diagnosis related (failure, delay, wrong) – 364 (67%); improper inspection/maintenance – 71 (13%); improper performance of treatment or procedure – 26 -5%).
The analysis found the three most common case types in interventional radiology claims made up 87 percent of those claims (improper performance of treatment or procedure – 32 (59%); improper management of treatment course – 9 (17%); retained foreign body—medical treatment – 6 (11%).
Of the top missed, delayed, or wrong diagnoses claims, 26% involved malignant neoplasms; 5% involved thrombi, hemorrhages, or abscesses in the cranium; and 4% were bone fractures.
Misinterpretation of diagnostic studies was present in 78% of radiologist medical malpractice cases. The top five diagnostic studies most frequently misinterpreted make up 98% of the diagnostic studies that were misinterpreted: CT scan (97 – 34%); X-ray (81 – 28%); MRI (50 – 18%); Mammogram (35 – 12%); Ultrasound (16 – 6%).
Communication among providers was the second most common contributing factor in diagnosis-related medical malpractice claims involving radiologists (appearing in 18% of such claims). Patient factors was the third most common factor contributing to patient injury in diagnosis-related claims with patient behaviors appearing in 14% of claims.
There were 71 cases of improper inspection and maintenance of equipment. In all of those cases, “CT scanners were new or received updates from the manufacturer. The hospitals and radiologists depended on the manufacturer to select the settings, which were later determined to be too high. In most cases, patients received excessive doses of radiation with repeat studies over the course of a year … The FDA attributed the initial errors to the manufacturer but stated that the hospitals and radiologists were responsible for checking each CT scanner for radiation emitted before doing a scan.”
The most common injuries associated with misinterpretation of a diagnostic study were undiagnosed malignancy (35%); patient death (26%); need for surgery/invasive procedure (22%); and, metastasis (18%).
For interventional radiology medical malpractice claims, the most common case type was related to performance of treatment or procedure (appearing in 59% of claims). Technical performance was a factor appearing in 76% of claims (in 65% of the claims, experts found that the correct procedure was performed appropriately, even when patients had undesirable outcomes from these high-risk procedures; in 11% of the claims, poor technique or incorrect body site was identified and resulted in indemnity).
For interventional radiology medical malpractice claims, communication between patient and provider appeared in 24% of claims (communication issues in interventional radiology most often were related to inadequate consent for invasive procedures or inadequate consent for other treatment options). Insufficient or lack of documentation was a factor appearing in 16% of claims. Selection and management of invasive procedures appeared in 16% of claims.
Improper management of treatment was the second most common case type for interventional radiologists, appearing in 17% of claims. Retained foreign body was the third most common case type, appearing in 11% of claims.
The most common patient injuries in interventional radiology procedures were need for surgery/invasive procedure (28%); death (22%); and, hemorrhage (19%) and puncture/perforation (19%).
If you or a loved one may have been injured (or worse) as a result of the medical negligence of a radiologist in the United States, you should promptly find a medical malpractice lawyer in your state who may investigate your radiologist medical malpractice claim for you and represent you or your loved one in a radiology medical malpractice case, if appropriate.
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