Radiology Malpractice Claims in the United States From 2008 to 2012: Characteristics and Implications

Harvey, H. Benjamin; Tomov, Elena Ivanova; Babayan, Astrid; Dwyer, Kathleen; Boland, S. J.; Pandharipande, Pari V.; Halpern, Elkan F.; Alkasab, Tarik K.; Hirsch, Joshua A; Schaefer, Pamela W.; Boland, Giles W.; Choy, Garry

doi:10.1016/j.jacr.2015.07.013

Cited by 33 publications

(17 citation statements)

References 33 publications

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“…It is therefore reasonable to believe that this problem is larger than it appears in our study. Compared with previous studies, 1.3-47% of the errors in radiology are related to communication issues (2,3,7,13,35). The large variation between these studies is related to differences in methods and aims of the studies.…”

Section: Discussionmentioning

confidence: 93%

“…Adverse events (AEs) are unintended injuries caused by medical management and not the disease process itself (1). The consequences of these incidents are a challenge (2,3), both to the health service and to society. As early as 1949, L. Henry Garland gave attention to radiologic errors when he declared that reaching a diagnosis is "the procedure of reaching the most probable conclusion based on the facts at hand" (4).…”

Section: Introductionmentioning

confidence: 99%

“…Studies of patient injury compensation claims in radiology are rare, and no studies from the Nordic countries have been found. Studies from the United States and Italy show that diagnostic errors (57-70%) are the main reason behind malpractice claims in radiology (2,3,7,8); this has remained unchanged for the last 30 years (9). Other studies show that many errors are caused by false-negative findings (34-80%), "satisfaction of search" (22%), and misinterpretation (9-22%) (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

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A national study of the causes, consequences and amelioration of adverse events in the use of MRI, CT, and conventional radiography in Norway

Bose

Bukholm

et al. 2019

Acta Radiol

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Background Rapid technological developments, increased complexity, and increased demand have made patient safety a challenge in radiology. Purpose To uncover the causes and consequences behind patient injury compensation claims in the use of MRI, CT, and conventional X-ray examinations, and to determine the system factors that need to be focused on in order to prevent these events. Material and Methods This descriptive cross-sectional study uses data acquired from The Norwegian System of Patient Injury Compensation. A total of 240 cases from 2012–2016 were included. Results According to our study, the main factors contributing to patient injury compensation claims in radiology were false-negative findings (48.7%), misinterpretation (13.1%), and “satisfaction of search” (12%). Another source of error was routines (8.7%), mainly where the patient should have been (further) examined using another modality. Other causes were related to communication (7.6%), procedures (2.9%), technical factors (2.5%), organizational and management factors (1.5%), competence (0.7%), location of the lesion (0.7%), patient factors (0.7%), false-positive findings (0.4%), and work environment (0.4%). These events led to delayed diagnosis and/or treatment in the range of 0–3650 days. Conclusion Errors of perception (false negative and “satisfaction of search”) and cognitive errors (misinterpretation) were the main reasons behind patient injury compensation claims in radiology. We suggest that a combination of double-reading, specialization, increased collaboration between professionals, as well as a reduction of unnecessary examinations should be considered to reduce adverse events in radiology.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A national study of the causes, consequences and amelioration of adverse events in the use of MRI, CT, and conventional radiography in Norway

Bose

Bukholm

et al. 2019

Acta Radiol

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“…[6] Diagnostic errors can be studied using several means, including data from: 1) malpractice claims, 2) autopsies, 3) questionnaire surveys, 4) case reviews, 5) hospital incident reports, 6) patient surveys, and 7) secondary reviews. [7] Diagnostic errors are a common reason for malpractice claims, [8][9][10][11][12][13][14][15] and claims data could provide vital information from patients' viewpoints. [2,3] For instance, Tokuda and colleagues summarized the findings from 274 malpractice claims filed at two local district courts in Tokyo and Osaka, and found that cognitive errors were the most common errors associated with these medical claims.…”

Section: Introductionmentioning

confidence: 99%

Factors and impact of physicians’ diagnostic errors in malpractice claims in Japan

et al. 2020

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Background Diagnostic errors are prevalent and associated with increased economic burden; however, little is known about their characteristics at the national level in Japan. This study aimed to investigate clinical outcomes and indemnity payment in cases of diagnostic errors using Japan's largest database of national claims. Methods We analyzed characteristics of diagnostic error cases closed between 1961 and 2017, accessed through the national Japanese malpractice claims database. We compared diagnostic error-related claims (DERC) with non-diagnostic error-related claims (non-DERC) in terms of indemnity, clinical outcomes, and factors underlying physicians' diagnostic errors. Results All 1,802 malpractice claims were included in the analysis. The median patient age was 33 years (interquartile range = 10-54), and 54.2% were men. Deaths were the most common outcome of claims (939/1747; 53.8%). In total, 709 (39.3%, 95% CI: 37.0%-41.6%) DERC cases were observed. The adjusted total billing amount, acceptance rate, adjusted median claims payments, and proportion of deaths were significantly higher in DERC than non-DERC cases. Departments of internal medicine and surgery were 1.42 and 1.55 times more likely, respectively, to have DERC cases than others. Claims involving the emergency room (adjusted odds ratio [OR] = 5.88) and outpatient office (adjusted OR = 2.87) were more likely to be DERC than other cases. The initial diagnoses most likely to lead to diagnostic error were upper respiratory tract infection, non-bleeding digestive tract disease, and "no abnormality." Conclusions Cases of diagnostic errors produced severe patient outcomes and were associated with high indemnity. These cases were frequently noted in general exam and emergency rooms

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“…Data from the USA show that diagnostic errors are by far the most common cause of malpractice suits, whereas failure to communicate and failure to recommend additional testing are both uncommon reasons for initiating a suit [1,5]. There are relatively few published data regarding malpractice suits against radiologists in Europe [6,7] compared with those against radiologists in the USA [1,2,5,[8][9][10][11][12][13][14][15][16][17]. The medical disciplinary law system in The Netherlands is unique and essentially different from a medical malpractice claim system, because its main objective is to maintain and improve the quality of healthcare rather than punishing healthcare professionals and/or financially compensating patients [18,19].…”

Section: Introductionmentioning

confidence: 99%

Medical disciplinary jurisprudence in alleged malpractice in radiology: 10-year Dutch experience

Kwee

2020

Eur Radiol

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Purpose To systematically investigate the frequency and types of allegations related to radiology practice handled by the Dutch Medical Disciplinary Court in the past 10 years. Methods The Dutch Medical Disciplinary Court database was searched for verdicts concerning radiology practice between 2010 and 2019. The association between the number of verdicts and time (years) was assessed by Spearman's rho. Other data were summarized using descriptive statistics. Results There were 48 verdicts (mean 4.8 per year). There was no significant association between the number of verdicts and time (Spearman's rho < 0.001, p = 0.99). Most allegations were in breast imaging and musculoskeletal radiology (each 18.8%), followed by interventional radiology, head and neck imaging, and abdominal imaging (each 12.5%), neuroradiology and vascular imaging (each 10.4%), and chest imaging (4.2%). There were 46 allegations against radiologists (95.8%) and 2 against residents (4.2%). The most common allegation (37.5%) was error in diagnosis. In 20.8% of verdicts, the allegation was judged (partially) founded; disciplinary measures were warnings (n = 8) and reprimands (n = 2). An appeal was submitted by the patient in 11 cases and by the radiologist in 3 cases. All appeals by patients were rejected, whereas 2 of the 3 appeals by radiologists were granted and previously imposed disciplinary measures were reversed. Conclusion Allegations against radiologists at the Dutch Medical Disciplinary Court are relatively few, their number has remained stable over the past 10 years, and a minority were judged to be (partially) founded. We can learn from the cases presented in this article, which may improve patient care. Key Points • The frequency of allegations against radiologists at the Dutch Medical Disciplinary Court is relatively low and has not exhibited any temporal change over the past 10 years. • These allegations reflect patient dissatisfaction, but this infrequently equals malpractice. • Knowledge of the circumstances under which these allegations have arisen may improve patient care.

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Radiology Malpractice Claims in the United States From 2008 to 2012: Characteristics and Implications

Cited by 33 publications

References 33 publications

A national study of the causes, consequences and amelioration of adverse events in the use of MRI, CT, and conventional radiography in Norway

A national study of the causes, consequences and amelioration of adverse events in the use of MRI, CT, and conventional radiography in Norway

Factors and impact of physicians’ diagnostic errors in malpractice claims in Japan

Medical disciplinary jurisprudence in alleged malpractice in radiology: 10-year Dutch experience

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