Who would be responsible?

[MikeTheGipper]

I read a case in the book "Better" that is written by Atul Gawande. It talks about a second year med student who has a chest x-ray that reveals a large tumor. The young mans father is a physicia and remembered that four years earlier his son had his wisdom teeth out and stayed in the hospital for one night. He also remembered that a chest x-ray would have been done after the wisdom teeth extraction. They pulled up the 4 year old x-ray and the tumor was there. The radiologist who read it stated that "Further evaluation of this is recoommended." However, the oral surgeon and surgical resident wrote in the patients chart that the chest x-ray was normal. Eventually a lawsuit is carried out and the patient wins. I'm curious as to who would be legally responsible for this? Would it be the oral surgeon and the resident? The radiologist made note of the tumor in the original x-ray, is that enough on the radiologists part or would he/she be responsible for making sure that the "further evaluation" be carried out? I found the case to be very interesting. Just wondering if you guys would know.

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[Terpskins99]

I read a case in the book "Better" that is written by Atul Gawande. It talks about a second year med student who has a chest x-ray that reveals a large tumor. The young mans father is a physicia and remembered that four years earlier his son had his wisdom teeth out and stayed in the hospital for one night. He also remembered that a chest x-ray would have been done after the wisdom teeth extraction. They pulled up the 4 year old x-ray and the tumor was there. The radiologist who read it stated that "Further evaluation of this is recoommended." However, the oral surgeon and surgical resident wrote in the patients chart that the chest x-ray was normal. Eventually a lawsuit is carried out and the patient wins. I'm curious as to who would be legally responsible for this? Would it be the oral surgeon and the resident? The radiologist made note of the tumor in the original x-ray, is that enough on the radiologists part or would he/she be responsible for making sure that the "further evaluation" be carried out? I found the case to be very interesting. Just wondering if you guys would know.

The oral surgeon is most at fault here, since he is the acting attending physician in this case. Attending physicians are also responsible for mistakes made by resident physicians in their charge (because in theory, the attending physician is always supposed to oversee everything that is being done by their residents). The hospital is also liable, since they employed the oral surgeon (and hence, are responsible for any actions made by employee physicians).

The radiologist did his job, for the most part. He identified the tumor, and recommended the lesion be further investigated. Nowadays most radiologists take the next step by actually calling up the physician and letting them know about the finding over the phone. But I don't believe calling up the physician is absolutely necessary, as far as the letter of the law is concerned. As long as the finding was documented.

 

[colbgw02]

I'm not an attorney, clearly, but my first that is that the radiologist met the standard of care in this example. Ideally (and this is certainly what we're taught), the radiologist would pick up the telephone before the dictaphone and tell the provider. Then he would document that conversation in the dictation. My intuition is that since the finding was not an emergent or urgent one the radiologist would not be at fault.