Errors in interpreting imaging studies, particularly CT scans, are the leading cause of patient injury involving diagnostic radiologists, according to a study by malpractice insurer The Doctor’s Company.
The study analysed about 600 malpractice claims against both diagnostic and interventional radiologists. These claims, closed between 2013 and 2018, were reviewed by physician experts, who also conducted medical record reviews to gain an accurate and unbiased understanding of what led to patient injuries.
The review revealed that most of the injuries (78%) in cases against diagnostic radiologists were due to misinterpretation of imaging studies. The most common injury from this misinterpretation of images was an undiagnosed malignancy. Notably, CT scans were the modality involved in 34% of the closed claims against diagnostic radiologists.
"The findings in this study, especially those involving CT scans, should be noted by all diagnostic radiologists and clinicians," said Bradley N. Delman, MD, a neuroradiologist and vice chair for quality in radiology at New York City's Mount Sinai Hospital. "It appears that communication between radiologists and clinicians is happening more effectively than shown in a prior survey of claims, but with 18 percent of injuries still associated with poor communication between physicians, we still have plenty of room for improvement."
With regard to claims against interventional radiologists, physician experts found:
- "Technical performance" was the leading cause of injury in 76% of cases, mostly involving patients who suffered poor outcomes after invasive procedures;
- In 65% of these cases, the appropriate procedure was performed correctly, however the patient was not satisfied with the outcome; and
- Only 11% of claims were because of poor technique or treating the wrong site.
As these findings suggest, there should be proper communication between the interventional radiologist and the patient prior to a procedure or surgical intervention, according to Darrell Ranum, JD, study author and vice president of patient safety and risk management with The Doctors Company. "It is critical for the [interventional] radiologist to clearly explain the potential for injury during the informed consent process and verify that the patient understands the risks," Ranum pointed out.
To help mitigate future risk, the study offers 11 strategies that radiologists can use in the practice of their profession. Those include tracking inspections of equipment and monitoring updates and settings, ordering repeat studies when views are of poor quality, and having a defined process for identifying and analysing diagnostic errors.
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