Radiologists are involved in 15% of diagnosis-related medical malpractice claims, second only to those of general medicine health care providers, according to a new report.
Claims naming a radiologist — totaling 595 in 2013-2017 — often involve significant patient harm and most frequently allege an incorrect or delayed diagnosis of a patient’s condition, according to an analysis of closed claims at Boston-based medical professional liability insurer Coverys published Tuesday.
Of the claims against radiologists, 80% of the missed diagnoses are alleged to have resulted from the misinterpretation of clinical tests “Among radiology claims alleging diagnostic failure, cancer diagnoses are the most frequent,” Coverys’ Red Signal report stated. “The top four cancer conditions associated with the alleged misinterpretation of diagnostic tests are breast, lung, pancreatic and ovarian. Many claims allege that a lack of follow-up on abnormal test results, such as from radiology or primary care, leads to a high-severity patient injury.”
More than 80% of missed diagnosis claims involved permanent injuries to the patient or death, according to the report, which recommended a series of risk management steps for the radiology profession. For example, the report suggested the development of criteria to determine whether a second read of a film must be performed, including the time frame for completion and confirmation back to the radiologist that the second read has been received, and the use of clear language and avoidance of interpretive phrases such as “cannot rule out,” “consistent with” or “likely represents.”
The report also recommended the implementation of checklists that can help circumvent some cognitive biases and decrease reliance on memory, the revision of standards to keep pace with technology changes and revisiting peer review practices to ensure they address how to measure and communicate periodic evaluation of clinical outcomes and compliance with established quality indicators and when performance may warrant closer review.