E5543. Picture Imperfect Evaluation of Medicolegal Concerns in Radiology
Authors
Star Lopez;
UCI SOM Computational Abdominal Radiology Lab; University of California, Irvine School of Medicine
River Wolf;
UCI SOM Computational Abdominal Radiology Lab; University of California, Irvine School of Medicine
Kayla Nakashima;
UCI SOM Computational Abdominal Radiology Lab; University of California, Irvine School of Medicine
Chang Shu;
UCI SOM Computational Abdominal Radiology Lab; University of California, Irvine School of Medicine
Erwin Ho;
UCI SOM Computational Abdominal Radiology Lab; University of California, Irvine School of Medicine
John Shahin;
UCI SOM Computational Abdominal Radiology Lab; University of California, Irvine School of Medicine
Roozbeh Houshyar;
UCI SOM Computational Abdominal Radiology Lab; University of California, Irvine School of Medicine
Background
This study aims to promote patient care and prevent costly litigation by educating radiologists on historical missteps in image collection, reading, and communication.
Educational Goals / Teaching Points
Given the deleterious impact litigation can have on medical practice and patient care, physician review of legal cases may help providers identify best practices and avoidable mistakes. According to data taken from 2016–2022 American Medical Association physician surveys, 31% of physicians have been sued during their careers. Radiologists reported the third highest rate of lawsuits, with 40.2% having undergone litigation. In other data, radiologists reported spending approximately 10% of their careers with an open malpractice claim. Time and energy dedicated to litigation detracts from the physician’s availability for ongoing patient care. To the extent possible, preventive measures, including retrospective evaluation of malpractice suits and enhanced communication techniques, may prevent unnecessary litigation and strengthen patient outcomes. With the aim of increasing diagnostic confidence and improving practice management, this exhibit reviews cases from multiple jurisdictions whereby plaintiffs alleged radiologist malpractice.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In medical malpractice claims, a plaintiff may prevail by establishing a provider breached their duty of care and said breach proximately caused injury to the patient. Adherence to the applicable standard of care implicates whether the provider met said duty. California Jury Instruction 501 defines standard of care as using “the level of skill, knowledge, and care in diagnosis and treatment that other reasonably careful [medical practitioners] would use in the same or similar circumstances.” Standard of care may extend to selection of testing methodologies and communication of diagnosis. For instance, adding contrast to imaging may define the radiologist’s ability to optimally identify pathology. Timely communication of an accurate diagnosis can ensure early detection and treatment, affording patients better outcomes. Although a lack of effective communication has upon occasion relieved a radiologist from the impact of a negligent diagnosis, other courts have found the radiologist liable for a breach of duty where the radiologist insufficiently communicated an accurate and time-sensitive diagnosis.
Conclusion
Retrospectively, cases show a radiologist’s early involvement and effective communication may enhance patient outcomes. Abiding by the standard of care, radiologists can proactively optimize outcomes by educating colleagues, subordinates, and patients. By providing guidance on the benefits and risks associated with different imaging options, radiologists establish the foundation for quality diagnostic follow-up. Each provider may assess which communication methods consistently work best given the nature of their practice, their patients, and the treating physicians involved.
