Given the breadth and scope of interventional procedures, it is perhaps not surprising that we see allegations of negligence in this area, related to both technical performance and “lack of warning” of possible side effects. As interventional radiology moves from its diagnostic sibling to recognition as a distinct specialty, we will likely see increased differentiation between the claims made against each group. Interventionists may find that their claims become more similar to those of these surgeons; Improving the availability and reduced costs of complex examinations such as CT and MRI scans can put diagnostic radiologists at the forefront of misdiagnosis in a number of specialties. Make sure that the history given to the radiologist contains all relevant historical questions. Radiologists should ensure that their reports accurately reflect the image they are commenting on. to the extent possible, including the degree of clinical certainty when diagnostic options are proposed (see case report on page X). If imaging reports indicate an abnormality, make sure you can reasonably rule out a serious underlying condition before suggesting benign diagnoses. Your report should be nuanced according to your confidence in the anomaly you have identified and not be too reassuring if significant clinical uncertainties remain. Between you and the attending physician or surgeon who ordered the imaging procedure, you must ensure that appropriate measures have been taken to rule out a serious underlying condition. The cost of clinical negligence claims continues to rise in many parts of the world. The increase in preventive screening among radiologists and the increasing use of interventional radiology by health care providers pose new risks for clinicians and providers` hospitals. In this article, we`ll look at what we can learn from investigating claims against radiologists. Methods: All supervisors, trainees and radiology alumni at our tertiary teaching hospital were interviewed using an electronic questionnaire.
Respondents were asked about their general knowledge of employment-related medico-legal issues and their willingness to undergo additional training. The survey also included two actual forensic scenarios and radiologists were asked to select the most likely outcome. In 2011 alone, more than 14,000 cases were opened to doctors around the world at the Medical Protection Society 2012 (MPS). Based on our experience in supporting our members with complaints and claims, we make the following observations. To avoid the occurrence of complaints, we recommend radiologists and referring clinicians who have requested radiological intervention to focus on the following areas: Today, improvements in cross-sectional imaging and post-treatment techniques have allowed CT to play a key role in the emergency assessment of hemodynamically stable patients with penetrating wounds. Identifying the trace of the wound, its extent and its relationship with surrounding organs is essential in choosing therapy and can be a major challenge for the forensic radiologist, who is expected to know the different injury patterns and even the legal aspects involved. A good understanding of these key medico-legal issues could positively influence the radiologist`s clinical routine and the behaviour of patients and referring physicians, resulting in a significant reduction in errors and malpractice. We hope that this volume will provide useful and accurate guidance on the main legal aspects of radiological clinical practice and open new perspectives on future challenges and developments in forensic radiology. A better 3D breast cancer screening experience™ – for everyone. The new 3Dimensions system™ is designed to provide radiologists with higher quality 3D images, a more comfortable mammography experience™ for patients, and an improved workflow for technologists. MPS`s experience shows that problems with proper diagnosis are the most common reason for resolving claims on behalf of radiologists, and in particular delays in cancer diagnosis. This shows how important it is to ensure that if there are still reasonable doubts about the presence of cancer after an image study, further investigations/evaluations are warranted.
Share your diagnostic uncertainty with your treating physician. As Halpin explains in his article, errors when playing image films can lead to perceptual errors (not seeing an existing anomaly;) or, as we suggest, misinterpretations (p. e.g., falsely suggesting that a lesion is filled with fluid when solid) (Halpin 2009). When providing possible clinical diagnoses in a radiology report, the radiologist should be careful to provide the appropriate level of clinical confidence and not overdo it. Fortunately, only a small fraction of adverse results due to medical errors actually result in a complaint or claim. This is largely due to a relationship of trust between physicians and their patients, as well as effective interpersonal skills before and after an adverse outcome. In the vast majority of clinical interactions in radiology, the radiologist`s contact with the patient is at best temporary, and often non-existent; The radiologist reports an isolated examination image and after the event, so it can be difficult to establish a relationship with a patient. This can make radiologists more sensitive to a complaint because the patient doesn`t see them as someone they`ve established a relationship of trust with – they`re just a name in a report. By far the most common reason for setting up on behalf of radiologists was fear of misdiagnosis (nearly two-thirds).
The underlying pathology in most of these cases involved a delay in cancer diagnosis (about one-third). Berlin L (2013) Medico-legal-malpractice and ethical issues in radiology: reporting the “missed” radiological diagnosis. AJR Am J Roentgenol 201(3):W516. doi:10.2214/AJR.13.10759 Results: A total of 359 trainees, participants and alumni were interviewed. There were 168 responses, corresponding to a response rate of 46.7%, F:M 48:112. Only 41% of respondents knew that by age 60, half would be involved in at least one legal dispute. All knew the most common causes of medical errors; However, one-quarter were unaware of the medico-legal resources available by radiology organizations; 85% of respondents agreed to participate in CME courses in medical law.