The Court of Appeals of Ohio (“Ohio Appellate Court”) upheld a lower court’s grant of a new trial to the Ohio medical malpractice plaintiff in its opinion filed on April 11, 2019, stating: “Based on the inconsistencies in [the defense expert’s] testimony relating to [the defendant radiologist’s] own testimony, we find that the trial court acted within its discretion in finding there was insufficient credible evidence supporting the jury’s decision that [the defendant] met the standard of care when he did not detect the change “as appreciable” in the July 2013 [MRI] Study.”
The Underlying Facts
In September 2006, the decedent (the plaintiff died during the litigation and her son was substituted as the plaintiff in his capacity as the personal representative of her estate) was diagnosed with Stage II-III left-sided breast cancer. Despite chemotherapy, a mastectomy of the left breast, and radiation, the decedent was diagnosed in June 2011 with metastatic breast cancer to the left parietal lobe of the brain. A surgical resection of the brain tumor was performed in July 2011. Because of the risk of recurrence of brain cancer, the decedent underwent brain screening MRIs for the purpose of detecting changes that might represent tumor recurrence.
The defendant radiologist read the decedent’s July 17, 2013 brain MRI study, stating in his report: “Stable surgical changes to the left parietal lobe and skull. Within limitations of a noncontrast examination, there are no appreciable new or recurrent metastatic lesions.”
In December 2013, the decedent had another brain MRI that detected a likely recurrence of the tumor. The plaintiff was diagnosed in March 2014 with recurrent metastatic breast cancer to the left parietal lobe that resulted in a large tumor in the “operative bed” — the site of the previous surgery. The decedent underwent a surgical resection of the recurrent tumor, but she experienced complications and died in November 2017.
The Ohio medical malpractice lawsuit alleged that if the defendant radiologist would have recognized the changes on the July 2013 MRI study, the decedent would have had less invasive treatment options (by the time it was finally detected, the tumor had grown too large for radiation therapy and resection was her only viable option, from which she suffered profound neurological deficits). The plaintiff’s radiology expert testified that the duty of radiologists is to detect and report changes when reading brain MRI images, specifically signs of a recurrent brain tumor.
The plaintiff’s expert testified that the change in the operative bed of the decedent’s brain was readily observant, objectively significant, and should have been detected in the July 2013 MRI study. The expert testified that the defendant radiologist did not meet the standard of care when he failed to detect the change and further reported that the study was “stable.” The expert further testified that based on the decedent’s history and because the change occurred in the operative bed (the site of her previous tumor), he would have reported the changes on the July 2013 MRI study and he would have described the changes as significant and are “concerning for recurrent or persistent tumor but are non-specific.” The expert testified that the July 2013 MRI study was not “stable” as the defendant reported, and that the MRI study performed in April 2013 also showed an abnormality but the abnormality was “subtle” and he was not critical of the radiologist for not reporting this abnormality.
The defense’s radiology expert testified that although there was a change in the July 2013 MRI study that he would have mentioned in the report, he would have also explained that it did not merit additional action because there was only one change. The defense expert testified that it is the radiologist’s job to bring changes to the attention of the treating physician to let that physician make an informed decision and that the change observed could have been a range of possibilities, including a recurrence of a tumor, but nevertheless testified that the defendant’s report that the study was “stable” was not a breach of the standard of care. The defense expert concluded that the defendant breached his standard of care when he did not detect significant changes in the July 2013 MRI study but did not breach his standard of care because the changes did not cross the action threshold, meaning that the changes were insignificant or subtle.
The defendant radiologist testified during trial that he sometimes looks at all the prior images, and sometimes he does not, admitting, however, that had he looked at all the prior studies, “he would have noticed a more significant change.” Even with this hindsight, the defendant testified that he met the standard of care when he read the July 2013 MRI study.
The Ohio medical malpractice jury returned a defense verdict after which the plaintiff filed a motion for new trial, arguing that the verdict was against the manifest weight of the evidence. The trial court granted the plaintiff’s motion for a new trial, finding that the defense verdict was not sustained by the weight of the evidence. The defendant filed an appeal.
Ohio Appellate Court Opinion
The Ohio Appellate Court stated that the trial court noted that the defendant did not testify that he recognized a subtle change but made a “judgment call” not to act upon it, determining that the manifest weight of the evidence did not show that the defendant used his discretion when making his report on the July 2013 MRI study. The Ohio Appellate Court stated “where both competing experts testify that they detected changes in the MRI images, and both stated they would have reported the change, it is incredible for the defense expert to then testify that [the defendant] did not breach his standard of care by not detecting the change, and more importantly, not reporting the change … [the defendant] did not detect the change that both [competing experts] found significant enough to warrant reporting if they had viewed the July 2013 Study.”
The Ohio Appellate Court held: “Based on the inconsistencies in [the defense expert’s testimony] relating to [the defendant’s] own testimony, we find that the trial court acted within its discretion in finding there was insufficient credible evidence supporting the jury’s decision that [the defendant] met the standard of care when he did not detect the change “as appreciable” in the July 2013 Study … [r]efraining from weighing the evidence, and viewing the evidence in a light favor to the trial court’s ruling, we conclude that the trial court did not abuse its discretion in granting appellees’ motion for a new trial. The trial court’s decision is not sufficiently contradicted by the record to render its decision unreasonable, arbitrary, or unconscionable. Accordingly, the assignment of error is overruled.”
Source Petruziello v. Aris Teleradiology Professional Corp., 2019-Ohio-1347.
If you or a family member may have been harmed due to a misread MRI in Ohio or in another U.S. state, you should promptly seek the advice of an Ohio medical malpractice attorney, or a medical malpractice attorney in your U.S. state, who may investigate your radiologist medical malpractice claim for you and represent you or your family member in a radiology medical malpractice case, if appropriate.
Click here to visit our website or call us toll-free in the United States at 800-295-3959 to be connected with medical malpractice lawyers in your state who may assist you.
Turn to us when you don’t know where to turn.