H. Benjamin Harvey MD, JD, Presenter: Nothing to Disclose

Sam T. Boland, Abstract Co-Author: Nothing to Disclose

Deborah LaValley RN, Abstract Co-Author: Nothing to Disclose

Garry Choy MD, MS, Abstract Co-Author: Nothing to Disclose

Medical malpractice liability is a pervasive concern among radiologists and shapes the way radiology is practiced.  Working with a professional liability insurer, we studied the radiology malpractice liability environment at a large integrated health system over a five-year period. 

All medical malpractice claims asserted against the health system from 1/1/2008 to 12/31/2012 were collected and analyzed.  Claims were evaluated based on the medical specialties involved, total liability costs incurred, and the disposition of closed cases.  Claims involving radiology were further evaluated to determine severity of the injury asserted, health care setting involved, primary allegation asserted, and, for missed diagnosis cases, the primary diagnosis missed.  When possible, comparison was made to the Comparative Benchmarking System (CBS), a large national HIPAA-compliant, medical malpractice claims database.

Over the five-year period, 1,126 malpractice claims were asserted against the health system resulting in $623M of total incurred liability.  Claims involving radiology made up 8% of the cases, representing the 5th most commonly involved medical specialty, compared to 7th nationwide.  Of the radiology claims, 57% were dropped or dismissed, 39% settled, 2% resulted in a defense verdict, and 2% resulted in a plaintiff verdict. The nature of the claims involving radiology was also assessed.  Of those claims, 52% involved a high level of injury severity (defined as injury resulting in death or permanent significant deficit).  The majority of the claims involving radiology involved the ambulatory setting (80%), followed by the inpatient setting (13%) and emergency department (7%).  The most commonly asserted allegation against radiology involved diagnosis-related negligence (65%), followed by treatment-related (39%) and medication-related (3%) negligence.  Cancer was the most commonly missed diagnosis representing 65% of missed diagnosis cases. There was little difference in the nature of the radiology claims compared to nationwide data. 

Radiology is a significant contributor to malpractice liability with claims commonly originating in the ambulatory setting, involving allegations of diagnostic failure, and resulting in high severity injuries. 

Medical malpractice claims data can offer valuable insight into the current liability environment and can direct strategies for reducing liability exposure. 

Harvey, H, Boland, S, LaValley, D, Choy, G, The Medical Malpractice Environment for Radiology at a Large Integrated Health System: A 5-Year Survey.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13025698.html