Robert Carl Smith MD, Presenter: Nothing to Disclose

Deirdre Mary Coll MBBCh, Abstract Co-Author: Nothing to Disclose

(1) Define perceptual errors in the interpretation of radiology tests; (2) Examine the current scientific evidence used at trials to establish that a perceptual error is a breach of the standard of care; (3) Educate radiologists as to the various causes of perceptual errors and their implications for malpractice liability

Using an electronic database, all radiology malpractice cases in the United States during the past fifty years that had published opinions were identified. For each case, the opinion was examined to identify cases where at least one of the causes of action against a radiologist was related to a perceptual type error. The scientific evidence and testimony used to define and establish a breach of the standard of care was then reviewed for each case.

Over 300 cases with published court opinions were identified. In the vast majority of cases: a perceptual error was defined as an abnormality missed at the time of interpretation where the abnormality is evident in retrospect; the only evidence introduced to establish the standard of care as well as to establish a breach of the standard of care was expert opinion testimony; in no case was scientific blinded interpretation used to establish or refute perceptual errors; in a small minority of cases, cognitive, technical or administrative errors were held to be contributory or causative of a perceptual error.

The current definition of perceptual error is misleading. Perceptual errors should be defined as "pure" or "mixed." Other types of error may be the actual cause of or contribute to a perceptual error and if brought to the attention of a jury could more readily establish a breach of the standard of care and result in malpractice liability for the radiologist. The most three most important factors that may be used in future trials against radiologists to establish malpractice liability are: excessive number of exams read; failure to obtain proper clinical information; failure of quality assurance of image acquisition

Smith, R, Coll, D, Error of Perception or Perception of Error: Perceptual Errors and Radiology Malpractice.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4419991.html