Most lawsuits against radiologists - 75% - are the result of a failure to diagnose or communicate any concerns in a test to the patient promptly.
To be sure, radiologists have a tough job and missing an abnormality is not necessarily malpractice. But, far too often, radiologists miss evidence of disease that a normal prudent radiologist would not miss. Approximately 31% are sued for a mistake during their careers.
Most radiology malpractice cases settle. Statistically, victims win 50% of these cases that go to trial.
Although some acts of negligence cover two or more of these categories, we focus on four general types of radiologist mistakes:Perception Errors
Perception error is a fancy term for when the radiologist fails to see what is there to be seen. Radiology is a skill. Some are simply better at it than others although the reality is that even a good radiologist can fail to see a positive finding on an x-ray, mammogram, MRI, or CT-scan. Repetition also helps sometimes. If a doctor is reading one MRI a month, the doctor is not likely to have the same ability as someone who is regularly reading and interpreting MRIs. These low volume radiologists make up a high volume of medical malpractice cases.
The most common complication involving radiologists' exams are any vascular injury, often requiring an angiography or other interventional procedures that utilize a series of images to guide what is intended to be a minimally-invasive procedure.
This is an interesting statistic on radiology malpractice. If radiologists are given a stack of radiographic, CT, or MRI studies that have abnormalities, approximately 30% of the abnormalities will be missed. But when you add in a lot of tests with no evidence of disease, the radiologist's overall miss rate drops 90%.
The most famous radiology perception malpractice case was the wrongful death lawsuit involving "Three's Company" star, John Ritter. Two years before his death, Ritter had gotten a CT that the radiologist interpreted as normal. Plaintiff's experts said it was not normal, and the doctors were on alert for an aortic aneurysm [learn more here]. The case was hotly disputed but settled for $14 million.Knowledge Errors
Knowledge errors occur when the radiologist simply does not have the requisite base of experience and knowledge to get it right. Either the doctor never learned or learned by forgot the knowledge to make the right call that the "ordinary, prudent radiologist" would have had. We have seen a lot of cases where the radiologist saw what was there to be seen but just did not know the implications of he was seeing.Communication Errors
With the exception of mammograms, the standard of care does not require radiologists to communicate directly with a patient. But while direct contact is not required, radiologist can't stop at just dictating a report and not making sure that the patient or referring doctor has been notified. Communication error radiology claims are usually larger cases not because the damages are higher than in a straight misdiagnosis case but because juries can get their mind around how little was needed to make sure the information was properly communicated so the patient could get the treatment he/she needs.Medication Errors
You would think radiology would be a relatively risk-free place for medication errors. You would think wrong. According to a report by the Center for the Advancement of Patient Safety, medication errors that harm patients are seven times more frequent in the course of radiological services than anywhere else in the hospital. Why? Just like we just talked about above, communication breakdowns are a big contributor. The most common errors were victims who got the incorrect dose or drug, not getting the drug they need, or not getting the drug correctly.Verdicts and Settlements in Radiologist Lawsuits
- 2016: $11.6 Million Verdict: Plaintiff goes to the ER with headaches, dizziness, and trouble standing. He gets a CT scan. The radiologist says he just has sinusitis. He is diagnosed with vertigo by a physician's assistant and sent home with instructions to follow up with his primary care doctor. He does follow up with his primary care for weeks with these same symptoms. He has a stroke and becomes disabled. Plaintiff settles with all defendant except the radiologist who is accused of misreading the CT scan which showed the blood vessel supplying blood to Plaintiff's brain was blocked,
- 2014: $16.7 Million Verdict: A Massachusetts jury awarded $16.7 million dollars to the daughter of a 47-year-old woman who died of lung cancer after a radiologist missed evidence of cancer in a chest X-ray. The deceased presented to the Brigham and Women’s Hospital with complaints of a persistent cough. She was sent for a chest X-ray to rule out pneumonia and was discharged with a diagnosis of an upper respiratory infection. Thirteen months later, she returned after her symptoms had worsened. A CT scan was ordered which showed advanced lung cancer. Before her death seven months later, cancer had spread to her kidney, liver, spine, and pubic bone. The Defendant claimed they were not provided with a full medical history that included a 30-year history of smoking and a mother who died of lung cancer. Her only daughter filed on her behalf and told the jury of their close relationship, and how she had raised her as a single mother. A jury awarded her the largest verdict of 2014 in the state.
- 2013, Maryland: $1,341,000 Verdict. A 77-year-old woman passes away three months after developing a staph infection while at University of Maryland Medical Center [Learn more about malpractice cases against UMMC.]. After injuring her back and undergoing a spinal fusion, she developed a staph infection at the surgical site. She passes away from complications from the infection. Her daughter files a wrongful death suit against the physician and the radiologist for failing to report the infection and not recommending the woman to remain immobilized. The radiologist claims the findings were reported. The Defendant physician claims that even if the woman had been immobilized, the infection could still have happened after the surgery. The radiologist was found 100% responsible for the infection and awarded the daughter $1,341,000.
- October 2012, Illinois: $3,000,000 Settlement: A 59-year-old woman is experiencing severe chest pain and sweating. She has a history of hypertension and tobacco use, so she is quickly taken to a local hospital via ambulance. During a cardiology consultation, the cardiologist discovers the chest pain was showing signs of movement from the center of the chest to her shoulder and down into her lower abdomen. The cardiologist orders an echocardiogram that reveals a severe aortic regurgitation and widening of the aortic route as well as a chest x-ray that discovers a tortuous aorta. The woman remains in the hospital for three days before he is given an abdominal CT scan. There, the radiologist discovers an intramural hematoma and suggests the woman undergo an EGD procedure. Yet, after the procedure, when she’s she should be confident that her problems have been fixed, she begins to experience extreme pain and then a loss of feeling altogether in her lower extremities. Another CT-scan is ordered, this time of her chest, which reveals an ascending aortic dissection that requires an emergency surgery. Unfortunately, the surgery comes too late, and the woman dies on the operating table. The plaintiff’s estate brings a medical malpractice suit against the cardiologist, his intern (who also cared for the decedent) and the radiologist. The plaintiffs claim the defendants failed to diagnose timely and treat the decedent’s aortic dissection. According to the plaintiffs, the cardiologist, and his intern neglected to include a differential diagnosis of an aortic dissection, even though a heart attack had been ruled out. The cardiologist denies the allegations, claiming that the primary differential diagnosis was myocardial infarct and could not be excluded until 24 hours had passed. He states that an ascending aortic dissection in a woman her age was incredibly rare. The intern also denies liability, agreeing such a condition was extremely rare and was operating under the direction of the defendant cardiologist. The plaintiff also claims that the radiologist was negligent in failing to diagnose bleeding occurring within the aortic walls and failed to alert the other defendants of a hematoma. The radiologist argues that even if the hematoma existed, they are very subtle and difficult to find. He claims not being able to diagnose/find the hematoma still fell within the standard of care. Although all defendants deny liability, the parties agree to resolve their case for $3,000,000.
- June 2012, Maryland: $691,565 Verdict: A Maryland man arrives at a hospital for a chest X-ray. The radiologist performing the X-ray reports the findings as normal. About one year following the initial X-ray, the man returns, consistent with the instruction of his neurosurgeon for pre-operative chest films before a laminectomy. While going over the films, the radiologist notices a nodular density in the man’s right lung. He decides to compare these films to the previous one from the prior year and notices the same abnormality. He indicates in the report the mass could have been a “nipple shadow” and recommends additional films with “nipple markers”. The films are never obtained. Another year passes and the man returns complaining of chest pains. Another X-ray is performed alongside with a CT scan. Both tests confirm the presence of a mass that is suspicious for malignancy. Multiple tests are performed, and the man is diagnosed with having adenocarcinoma (a type of cancer) in his right lung. The patient decides to undergo radiation and chemotherapy, but unfortunately, cancer had metastasized, and he passes four months after the initial diagnosis. The man’s estate brings a medical malpractice suit against the neurosurgeon for violating the standard of care. Plaintiffs claim the neurosurgeon failed to review the pre-operative films and if he had done, would have noticed the mass. Plaintiffs also claim had the defendant violated the standard of care and delayed the necessary treatment, leading to the man’s death. The defendant denies all liability and disputes any violation of the standard of care. A Montgomery County jury finds for the plaintiffs and awards $691,565.
- October 2011, California: $6,400,000 Settlement: A 14-year-old girl wakes up with severe back pain and numbness in her legs. She is rushed to UC Davis Medical Center by her mother and admitted for emergency care. There, she receives an MRI that reads as normal. The doctors decide to treat the teenager for Guillain-Barre syndrome, a condition where the immune system mistakenly attacks the nervous system. Such a condition is quite serious, especially for a girl at this age, and she remains in the hospital for up to a week for treatment until she can regain feeling in her legs and can walk. For four years, the girl is in and out of her pediatrician’s office with similar complaints until she once again wakes up with the same symptoms of leg numbness and back pain. She is once again rushed to an emergency room, this time at Methodist Hospital in Sacramento. She gets another MRI, which shows an arteriovenous malformation on her spine. They soon discover the malformation had bled out and damaged her spinal cord. That same evening an emergency surgery is performed to prevent further harm. Unfortunately, the damage had already been done, and following the surgery the, now, young adult is paralyzed from the waist down. The young woman sues UC Davis Medical Center for medical malpractice for breaching the standard of care. Plaintiff’s counsel claims the radiology department failed to identify correctly the arteriovenous malformation on her spine. Using evidence from an internal log book, they presented an entry stating the axels had not been done during the MRI per the physician. The defendants claim this was because the girl, who was 14 at the time, had been uncomfortable with the machine. However, plaintiff’s counsel points out she was sedated during the MRI and did not have any difficulty with the study. A neuroradiology expert for defense counsel testifies that while the mass was present in the initial MRI, it was subtle and within the standard of care to miss. Defense counsel also blames the plaintiff’s parents for only going to her pediatricians during the four years between the hospital visits; even though her discharge paperwork advised that if the symptoms were to return she should return to the hospital. They claim that had she returned to the hospital, the neurology department would have eventually properly diagnosed the plaintiff. The just finds the hospital 58% liable for injuries and her parents 42% at fault. They award the plaintiff $7,624,318, which is reduced in a post-trial settlement to $6,400,000.
- May 2011, Indiana: $2,600,000 Verdict: A man is being treated in the ER at St. Margaret Mercy Healthcare in Hammond, Indiana. An emergency medicine specialist orders a chest x-ray, but for some reason or another, the physician is never informed of the contents. The man is considered to have a non-serious condition, is discharged, and informed to follow-up with his doctor. However, the man decides not to do so. Almost one year after his visit to the ER, the man is diagnosed with lung cancer. He chooses to undergo radiation treatment but opts out of chemotherapy. The man attempts to present the situation to a medical review panel, but the panel unanimously agrees that the physicians at St. Margaret did not fall below the standard of care. He then decides to file suit against St. Margaret for hospital negligence. He claims that his original x-ray was suspicious for lunch cancer and that had he had known so, he would have undergone a CT-scan that would have lead to an earlier discovery of his cancer. The defendants dispute the accusations, claiming that the delay in diagnosis caused no significant harm and that the plaintiff could have lessened his damages by agreeing to chemotherapy treatment. They also claim that the delay in diagnosis was partially the fault of the plaintiff as he did not follow-up with his primary physician, and had he had done so, the radiologist’s recommendation for a CT-scan would have been seen. After a four-day trial, the jury awards the plaintiff $2,600,000.
- May 2011, Washington, D.C.: $1,750,000 Settlement: A 63-year-old woman arrives at a local hospital for a scheduled angiography. Before the procedure, the vascular surgeon orders a chest X-ray. The radiologist discovers a two-centimeter mass in the left lung and recommends a CT-scan for further investigation. Not only is the CT-scan not performed, but the woman is not informed of the X-ray findings until three years later when a chest X-ray is performed during treatment for pneumonia. By that time, the lung malignancy had grown to six centimeters. The presence of an adenocarcinoma is confirmed after a bronchoscopy is performed and an MRI reveals metastasis to the brain. Consequently, she must undergo extensive chemotherapy and surgery to remove the metastasis. The woman sues the hospital for violating the standards of care. She claims the radiologist failed to inform the surgeon of the initial x-ray findings. She also claims the doctor neglected to follow-up with the necessary procedures to rule out the presence of malignancy. The defendants deny liability, but the parties agree to settle for $1,750,000.
If you have been injured as the result of medical or hospital malpractice or negligence, call us at 800-553-8082 or click here for a free consultation.Resources for Both Counsel and Victims
- Overview of Health Provider Negligence Claims (we explain what you can expect)
- Samples and Information for Lawyers
- Sample Medical Malpractice Complaint (sample complaint filed by our lawyers in a medical malpractice case)
- Sample Attorney Deposition of Medical Malpractice Doctor (sample deposition of defendant doctor accused of medical malpractice)
- Requirements for Certificate of Merit in Maryland Malpractice Cases
(sets forth what is required to bring a medical malpractice claim in Maryland)
- Sample Attorney Deposition of Defendant Doctor's Medical Expert (sample deposition of defendant's expert's deposition in a Maryland medical malpractice case)
- Maryland Statute of Limitations (discusses how much time you have to bring a claim)
- Bringing Medical Error Claims (explains what is needed to file a lawsuit in Maryland)