E1263. Relative Prevalence and Characteristics of Malpractice Litigation Involving Radiology Trainees
  1. Kenneth Tharp; Emory University School of Medicine; University of North Dakota
  2. Casey Branach; University of Michigan
  3. Richard Duszak; Emory University School of Medicine
To assess the relative prevalence and characteristics of medical malpractice litigation involving radiology trainees.

Materials and Methods:
We performed a retrospective keyword search of the subscription-based LexisNexis legal database of public judicial records to identify all state and federal lawsuits between 2009 and 2018 yielding formal appellate and lower court opinions (precedent setting “complex litigation”) potentially involving physician trainees. All screen-identified records were then individually, manually, and systematically reviewed to 1) confirm that they truly involved medical malpractice allegations and 2) verify direct involvement in the alleged matter by a postgraduate physician trainee. Whenever judicial documents permitted, cases were categorized by 1) trainee specialty, 2) whether the trainee was individually named as a defendant, 3) trainee postgraduate year (PGY), 4) case disposition, and 5) both location of origin and jurisdiction. Incidence rates were calculated across specialties using residency match data. Radiology lawsuits were additionally categorized by the dominant allegations put forth by plaintiffs.

Initial LexisNexis Boolean database search yielded 8,935 potentially relevant lawsuits with 580 individually confirmed as malpractice cases materially involving physician trainees. Over time, cases trended downward (annual high 70 and low 37). Most originated in New York (195/580; 33.6%), Ohio (41; 7.1%) and Pennsylvania (34; 5.9%) and involved surgery (204; 35.2%), obstetrics/gynecology (114; 19.7%), and medicine (105; 18.1%) trainees. Of the 309 cases with known outcomes, defendant physicians prevailed in 238 (77.0%). The incidence rate for trainees across all specialties was 0.63 per 1,000 trainee years. Complex litigation incidence rate ratios were highest for obstetrics/gynecology (4.25; 95% CI 3.46-5.21) and surgery (2.62; 95% CI 2.21-3.11). Only 23 cases (4.0%) involved radiology trainees with an incidence rate ratio of 0.79 (CI 0.52-1.20). Radiology litigation most frequently involved alleged missed diagnoses (14/23; 60.8%) and procedural complications (7; 30.4%). Of 13 radiology cases with known outcomes, defendant radiologists prevailed in 9 (69.2%).

Complex medical malpractice litigation involving physician trainees is infrequent and decreasing over time, with a disproportionate geographic distribution of case burden. Lawsuits involving radiology trainees are uncommon, less likely than those for many non-radiology trainees, and typically involve alleged missed diagnoses or procedural complications. Defendant radiologists usually prevail. These findings contribute to the understanding of radiologist trainee malpractice risk and could inform curricula to mitigate malpractice risk, both during and after residency.