Lyndon Luk BS, Presenter: Nothing to Disclose

Stephen R. Baker MD, Abstract Co-Author: Consultant, One Call Medical, Inc

Jeremy Whang MD, Abstract Co-Author: Nothing to Disclose

Hye-In Choi, Abstract Co-Author: Nothing to Disclose

Ronak H. Patel BA, Abstract Co-Author: Nothing to Disclose

To determine the prevalence, causes, and outcomes of malpractice suits related to radiologic studies of the chest in a survey of 8,401 radiologists.

The malpractice histories of 8,401 radiologists from 47 states were evaluated from credentialing data, required of all radiologists participating in the network of One Call Medical Incorporated, a broker for CT/MR in workmen’s compensation cases. 32% of the radiologists had at least one suit. Of the 4,043 total claims, 505 cases (12.5%) were related to the chest. In 457 of these cases, a satisfactory description of the allegation(s) could be derived from the accompanying narrative.

46.6% (213) claims were from patients diagnosed with lung cancer. The alleged error was a failure to recognize the tumor by imaging studies in 185 cases. In 14, the alleged error was a failure to communicate findings to either the referring physician or to the patient/family. Other commonly missed diagnoses include aortic dissection (41 cases – 9.0%), pulmonary embolus (26 – 5.7%), and retained foreign body (23 – 5.0%). Complications of procedures performed by radiologists, including lung biopsy, thoracentesis, and line placement, together comprised 7.9% (36). Most cases resulted in a settlement for the plaintiff. Failure to diagnose a retained foreign body or aortic dissection resulted in payment to the plaintiff in 87.5% and 80.6% of cases, respectively. Claims involving lung cancer and pulmonary embolus were settled in favor of the plaintiff in 68.3% and 62.5% of cases, respectively. Average awards for failure to recognize pulmonary embolus was $508K. Aortic dissection awards were $288K and retained foreign bodies incurred payments averaging $97K. Lung cancer claims resulted in an average payment of $243K.

Lung cancer cases account for nearly half of all chest-related malpractice suits. The majority of claims, regardless of cause, were settled in favor of the plaintiff. Award amounts varied considerably, with failure to diagnose pulmonary embolus the most costly at $508K.

Malpractice claims related to the chest are common, comprising 12.4% of all malpractice claims. In this category, the misdiagnosis of lung cancer was by far the most common

Luk, L, Baker, S, Whang, J, Choi, H, Patel, R, Chest Malpractice Cases Derived from the Credentialing Data of 8,401 Radiologists.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11008464.html