When a radiology finding is missed, make case defensible
Did a radiologist contact the ordering physician about a finding? If so, it is important for the radiologist to document why the call was made, when the conversation with the ordering physician occurred, and the substance of any conversation had, advises Ryan M. Shuirman, JD, an attorney at Yates, McLamb & Weyher in Raleigh, NC.
"The cases we see often raise the question of whether a radiologist should call the ordering physician to report an acute or worrisome finding," Shuirman says. "A plaintiff's expert is likely to offer an opinion that when in doubt, a call should be made."
This situation might result in the radiologist frustrating the ordering physician when the finding has little clinical correlation to the patient. "But it is often important for the radiologist to establish why some calls are made and why other calls are not," Shuirman says. "Moreover, it is important for the radiologist to clearly document what other recommended follow-up studies may have been discussed."
Here are some factors that can make these claims more defensible for the ordering physician:
• Distinguishing between findings which they made on their own read versus findings simply relayed by the radiologist.
"We have seen several cases in which it is nearly impossible to determine when or if an ordering physician received results from a radiology study from a simple review of the chart," says Shuirman.
• Investigating equivocal findings.
"Too often, we see claims where an equivocal radiology study was not investigated further," he says.
A plaintiff's expert can retrospectively look at a later study and extrapolate what would have and should have been found, if only the initial ordering physician had thought to investigate further, explains Shuirman.
• Documenting communications with the radiologist, including addressing any discordant findings between the ordering physician and the radiologist.
"This would help reveal the analysis and decision-making of the ordering physician, which should make it easier to defend, if such judgment should be questioned in a claim or suit," says Shuirman.