Misinterpretation of scans, particularly those produced using computed tomography, are the leading cause of patient injury in diagnostic radiology.
That’s according to an analysis of nearly 600 malpractice claims against radiologists, closed between 2013 and 2018, and released on Tuesday Dec. 3. Physician-led malpractice insurer the Doctor’s Company noted that about 78% of injuries in cases against diagnostic radiologists were the result of image misinterpretation. Most commonly, the injury was an undiagnosed malignancy, the analysis found.
CT scans were the imaging technology involved in the largest portion of closed claims at about 78%. One key takeaway for radiologists is the need to improve information exchange among providers and with patients.
"The findings in this study, especially those involving CT scans, should be noted by all diagnostic radiologists and clinicians," Bradley Delman, MD, a neuroradiologist and vice chair for quality in radiology at New York City's Mount Sinai Hospital, said in a statement. "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."
Meanwhile, “technical performance” was the leading factor in claims against interventional radiologists, accounting for about 76% of claims. Most often, that included patients suffering poor outcomes from invasive procedures. In about 65% of such cases, radiologists performed the appropriate procedure correctly, but the patient was unhappy with the outcome. Just 11% of claims against interventional radiologists were because of poor technique or treating the wrong site.
"These findings indicate the importance of communication between the interventional radiologist and the patient prior to the surgery or procedure," study author Darrell Ranum, vice president of patient safety and risk management with the Doctors Company, said in the announcement. "It is critical for the radiologist to clearly explain the potential for injury during the informed consent process and verify that the patient understands the risks."
The analysis also offers 11 strategies that radiologists can employ to help mitigate future risk. 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 analyzing diagnostic errors.
You can read the entire analysis here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.