oreosandsake

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i'm on a EM rotation now (the last one of my med school career!) and I see the rads guys readnig a whole bunch of films all night...

the other night the guy missed a giant dermoid cyst in this patient's abdomen.

my attending checks all his own films and called him back for a "re-read"

just curious, since i know radiologists have a lot of pressure and have to make the diagnoses on so many cases every day, how often they get sued for missing things...
 

colbgw02

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My quick attempts to find some literature on the subject were unsuccessful, but anecdotally, I would put radiologists in the middle tier vis-a-vis malpractice. We're definitely below OB/GYNs and surgeons. Anesthesiologists may have more liability as well, but again, I don't have any data on that.

Not surprisingly, cancer is probably the biggest source of our malpractice claims, so anyone who does a substantial amount of mammography is bound to get sued. "Missing" pulmonary nodules on CXR seems to be a decent source of liability as well, since the plaintiff can always find some clown to testify that the now-obvious 5 cm mass was clearly present 10 years ago.

Personally, I feel compelled to include a lot of low-yield differentials in many of my reports for that one in a thousand case, but I don't think that phenomenon is particularly unique to radiology.
 

MossPoh

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My evidence is strictly anecodtal as well since I only know what I witnessed with my dad and his partners. Much of the time, it is very regional in how often you get sued. That applies to all specialities though and not just radiology. While in south florida, he was named in lawsuits (not the only doc) at least one to two times per year. Once moving to a small town in the midwest he was named once in his 20 years there.

Errors are inevitable in every field. You just have to do your best to develop the knowledge base and routine to minimize those errors.
 

Goober

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My evidence is strictly anecodtal as well since I only know what I witnessed with my dad and his partners. Much of the time, it is very regional in how often you get sued. That applies to all specialities though and not just radiology. While in south florida, he was named in lawsuits (not the only doc) at least one to two times per year. Once moving to a small town in the midwest he was named once in his 20 years there.

Errors are inevitable in every field. You just have to do your best to develop the knowledge base and routine to minimize those errors.
This is pretty accurate. Specialty partly determines this with mamms, IR probably higher than Body/MSK/general. But as pointed out what part of the country you are in is more important. South Florida has one of the worst reps for lawsuits. Getting named in one every year is not crazy. Philly is pretty bad as well as other parts of the northeast and probably most large metro areas.
 

oreosandsake

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mistakes are inevitable and it feels like these cases are unfortunate for all the parties involved. I read in the ER forum about the ER doc who documented his 5 year debacle with attorneys and courts - missing work, sleepless nights just because of one case which he finally won.

I tell people that physicians get paid because they are willing to shoulder a lot of liability. that they are paid in "nickels" but sued for gold bars.

I have heard of physicians losing cases for $10 Million dollars.

many if not most physicians won't make that money in an entire career.
 

PistolPete

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So what happens when you lose a $10 million case? How much does the physician have to fork over and how much does the insurance company cover?
 

Goober

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So what happens when you lose a $10 million case? How much does the physician have to fork over and how much does the insurance company cover?
Your insurance policy will determine how much they will cover. Most policies will cover in the 1-3 million dollar range. Typically lawyers go after this money because it is easy to collect on. Once you start going after personal finances it gets more tricky to collect this money because there are many ways of keeping them from getting it- not that this will stop them from trying!

It is actually pretty unusual to get a single doctor responsible for a 10 million dollar case. More commonly the "big" lawsuits sue a whole bunch of people (every doctor remotely involved, hospitals, imaging centers, ect.) and see who they can get money out of...
 

penguin24

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Speaking about physicians in general, one attending told me that American physicians get sued about once every 7 years, on average.
 

BenFelson

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I'm in a neuroradiology fellowship at the U of Arizona.
It's high volume and high risk.
Just about every week an attending will be served. The most recent was last week when a screw was not mentioned in the neck.
It's tough since the attendings cosign work done by residents. And the place is big into trauma.
I got sued twice in 17 years of practice.
My wife just got sued in Anesthesia for the first time after 15 yrs. I think her case will be dropped. These lawyers are leeches. And Obama is in league with all of them.
 
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most radiologists get dragged into lawsuits because of the high volume of cases they see. i have been in practice for 12 years and have been sued twice, both cases dropped for stupidity. most of my partners have been sued the same amount. some never get sued. it is a role of the dice. i think we get sued more than internists, but less than surgeons.
 

TheRadiologist

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In 18 years as an attending, I was sued three times. All three were dropped because they had no case. It took them seven years to drop me from one of the cases which had no merit. In those seven years, I had to list the pending case on my applications for hospital privileges. I was deposed in two of these cases. This was very stressful and huge waste of time. In one of these cases, I was dropped from the case the day before the trial was scheduled to start. I had spent about 200 hours preparing for the trial. The one benefit of having a pending case is that you get out of jury duty if it comes up.


In radiology , cases with no merit are easier to defend because the images are still available and experts can testify the standard of care was met. When we do miss something, it is hard to defend because the plaintiff's experts have all the images and can testify that you did not meet the standard of care.
 
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gluon999

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TheRadiologist: good info, thanks. Do you mind sharing if you are in a particularly litigious part of the country or is three lawsuits more or less average in most places? Also do you know how rads compares to Internal med and Surgery in terms of frequency?
 

TheRadiologist

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I am in Illinois. I am not sure where this state ranks in terms of litigation, but I live in Cook County which is the worst county in the state for malpractice claims. Although my hospital is not in this county, the plaintiff’s attorneys always do their best to have the trial in Cook County so they have a better shot at getting a good judgment. If I had known this earlier, I would have built my house outside Cook County.

I do not have any hard data about how often radiologists get sued other than the anecdotal experience from my own group. The others in my group have had about the same frequency of suits that I have had. My guess is that radiologists are sued more frequently than most clinicians, because of the high volumes they deal with. I read about 13,000 cases year. That is 13,000 opportunities to screw up.

Many suits deal with the failure to communicate results. For example, if you find a lung nodule on a pre-op chest X-ray and no one follow up on the finding because the report got lost, the radiologist may end up trouble even though he read the study correctly. If there is a significant finding, you should call the patient’s clinical physician and document the communication in the report.

All radiologists miss finding, but fortunately most of these do not result in adverse outcomes and do not lead to litigation. They can not sue you just for missing stuff. They can only sue you if you missed something and that miss leads to an adverse outcome.