Radiology is responsible for a large number of diagnosis-related malpractice claims. Clinical tests are most often involved.
• Most diagnostic radiology cases involve cancer.
• Malpractice cases involving fast-moving cancers are particularly difficult.
• Hospitals must have a system for tracking diagnostic results.
Radiology is the second most common source of diagnosis-related malpractice claims, behind general medicine, according to a recent analysis from Coverys, a medical malpractice insurer based in Boston.
Radiology claims are common and can be costly, says Robert Hanscom, JD, vice president of business analytics with Coverys. For radiology, misinterpretation of clinical tests is the most likely allegation in lawsuits.
The analysis examines 10,500 closed medical professional liability claims across a five-year period from 2013-2017. Claims naming a radiologist often involve significant patient harm and can delay the accurate diagnosis of a patient’s condition, Hanscom notes.
The analysis includes these findings:
• About 15% of malpractice claims with a diagnosis-related allegation involve radiologists.
• Within diagnosis-related claims, 80% result from the misinterpretation of clinical tests.
• More than 80% of claims involved permanent injuries to the patient, or death.
• Among diagnostic failure claims involving radiology, the largest number of cases involve a missed or delayed diagnosis of cancer.
• The types of cancer most often associated with misinterpretation of diagnostic tests are breast, lung, pancreatic, and ovarian.
Diagnosis-related allegations are the most common malpractice claims, and the most expensive. General medicine accounts for the most cases, but radiology is not far behind, Hanscom says.
“Radiology is uncomfortably high. We were surprised by that and thought radiology might be lower in the prevalence of these claims because there has been a lot of work done over the last decade,” Hanscom says.
“Radiologists are still being named in these suits, either the primary defendant or just involved, and may bear some responsibility for what happened. The ones where radiologists are being pulled in are the cancer diagnoses, and that’s no surprise.”
Pancreatic and ovarian cancer cases are particularly difficult and costly, Hanscom says, because those cancers are so fast-moving.
“A delay in diagnosis with those cancers can mean the difference in the patient living or not, so those are very serious cases,” Hanscom says. “Breast and lung cancer don’t always mean that, but they do involve a great deal of radiologist involvement. These are all high-severity injury cases, as opposed to other malpractice cases like surgical injury cases that might fall into medium severity.”
One of the key lessons from the data is the need for a closed-loop tracking system to identify critical test results, Hanscom says. Communicating test results during transitions of care also is critical, he says.
“That often is a phase of care where things get lost and things that are critical don’t get to the person who needs to receive it,” he says.
“Also, there must be a system in place that identifies situations that need attention. Radiology reports tend to go on at length and everything can seem like it has equal importance, so there must be a way for physicians to recognize that this particular paragraph needs your attention and focus.”
• Robert Hanscom, JD, Vice President of Business Analytics, Coverys, Boston. Phone: (800) 224-6168.