Radiologists are expert searchers. Doctors rely on radiologists to look inside patients’ bodies for critical information they can use assist in their diagnostic process. Radiology is also commonly used to identify abnormalities before they become problems, such as in cancer screening. In fact, many radiology cases are part of a failure to diagnose cancer claim. They are trained to look at images of X-rays, CT scans, ultrasounds, and MRIs. Sometimes, though, radiology misses may have devastating effect on a patient or their loved ones.
Radiology misses occur most often when a radiologist fails to appreciate an abnormality on an imaging study. This may be due to the radiologist simply not seeing it, or misunderstanding what the abnormality is. The most common types of radiology misses are due to errors in perception, errors in knowledge, or errors in communication.
An error in perception can occur several ways. One is when a radiologist misunderstands the significance of an abnormality and ascribes it to something benign. For example, a CT may be ordered to look at the arteries around the heart. The indication for the CT comes to the radiologist as “suspect coronary artery calcification.” With that information, the radiologist will focus their search on imaging slices that include the coronary arteries. In so doing he or she may miss the asymptomatic tumor at the top of the patient’s liver because it was far away from the area he or she was focusing on. Another way this type of error might occur is when a provider fails to appreciate the markers for cancer, and describes the abnormality as benign. Finally, a radiologist might just miss what is there to be seen, such as a vertebral fracture or the dissection of a blood vessel.
Knowledge errors happen in much the same way as perception errors, but they occur due to the radiologist’s lack of training, temporary forgetfulness, or lack of recent exposure to certain types of imaging. A radiologist may see what is there to be seen, but may lack the requisite training to recognize its significance. Many radiologists specialize in imaging of certain areas of the body. While a specialist in mammography may be able to pick out subtle abnormalities more readily than a general radiologist, all radiologists are expected to be reasonably prudent in identifying abnormalities. Some radiologists end up reviewing one or two abdominal MRIs on a shift; others will see a dozen or more in the same timeframe. The second radiologist, by sheer volume of exposure, is going to be able to identify abnormalities better than the one who sees that type of study occasionally.
Another scary reality is when a radiologist properly identifies an abnormality on the imaging report, but the ordering provider does not act on it. Sometimes the language of the abnormality is buried low in the imaging report, therefore not immediately obvious. The provider may not understand the significance of the finding, may overlook the radiologist’s recommendation for follow up imaging, or simply forget to communicate the abnormality to the patient. What is particularly tragic about these types of cases is that, really, only a little bit more effort was needed to make sure the ordering provider or patient was informed of the abnormality.
Radiology misses can end up in delays to diagnose cancer, failure to diagnose spinal cord compression, failures to diagnose vascular conditions, or in wrongful death cases, to name a few. Radiologists are among the most frequently sued medical professional in malpractice cases. Of those cases, nearly two thirds were for failure to diagnose or a delay in diagnosis. We have handled many of these radiology misses type of cases.
If you think you or a loved one is a victim of medical malpractice for a radiology miss, contact us.
When I was 13, I had severe hip and joint pain, and no doctor could figure out what was wrong. They were even telling me to exercise more for a painfully long time. Finally, I found out I had slipped capital femoral epiphysis in my hip – previously missed by a radiologist. I could not have had a better experience than with Tyler Goldberg-Hoss. He guided me through every step and never talked down to me or my parents. With the recovery I received, I now know my medical needs will be taken care of in the future.
Andrew M., Everett, WA
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