Most lawsuits against radiologists - 75% - are the result of a failure to diagnose or communicate any concerns in a test to the patient promptly.
Radiologists have a tough job. Missing an abnormality is not always 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 is vascular injuries, 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.
- Here is an example perception radiologist malpractice lawsuit filed in 2017 involving misdiagnosed ovarian cancer
- Here is another involving breast cancer
- Another one in an aortic dissection misdiagnosis case
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 what she was seeing.Communication Errors
Except for mammograms, the standard of care does not require radiologists to communicate directly with a patient. But while direct contact is not required, radiologists 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.
Yes. In fact, radiology has one of the highest rates of medical malpractice claims in the profession. Approximately 31% of all practicing radiologists will get sued for medical malpractice at least once in their careers.
Over 75% of medical malpractice claims against radiologists are based on diagnostic errors or failure to diagnose. Most failure to diagnose cases are based on the radiologist failing to properly identify signs of disease on an x-ray, mammogram, MRI, or CT scan. Failure to diagnose breast cancer and lung cancer are the most common types of diagnostic negligence claims against radiologists.
Compared to medical malpractice cases against other types of doctors, radiologist malpractice cases have a very high rate of success. Over 80% of radiology malpractice lawsuits end in an out-of-court settlement. When cases against radiologists do go to trial, the plaintiffs win about 50% of the time, compared to 10-15% in cases against other types of doctors.
Below are some verdicts and settlements in malpractice claims against radiologists. These examples of malpractice in radiology are very helpful in understanding the settlement values of these claims.
But these stories come with a caveat. You cannot determine the value of one claim by looking at another even if the cases appear to be the same. There are just too many variables at play. So use these and learn from them but do not take their instructive value to an illogical extreme.
2019, Maryland $2,582,529 Verdict: A 56-year-old female decedent undergoes a diagnostic mammogram that is interpreted as normal. The following year a subsequent mammogram reveals a large tumor and leads to a diagnosis of breast cancer. By that time the cancer had already spread outside the breast and she tragically dies two years after the diagnosis. Her family sues American Radiology for negligently failing to identify the tumor in the first mammogram. The misdiagnosis lawsuit goes to trial in Baltimore County and the jury awards $2.5 million in damages.
2018, Massachusetts $2,800,000 Verdict: Plaintiff had previously been diagnosed with sarcoma in his left shoulder. The cancer was successfully treated with chemotherapy and surgical removal. During the years that followed plaintiff had regular chest and shoulder CT scans to monitor for evidence of recurrence or metastasis to his lungs or. Five years after his initial treatment the plaintiff had a new cancerous mass in the same shoulder, however, the radiologist misread his CT scan as normal. Months later the lump had doubled in size and was diagnosed as cancer. By that point, the tumor had spread into his nerves and his arm had to be amputated at the shoulder. He sued for malpractice claiming that the radiologist failed to properly read the CT scan where the new mass appeared, resulting in the loss of his arm.
- 2018, New York $4,500,000 Settlement: A urologist sent a 49-year-old male plaintiff to the radiologist for abdominal CT scan. The radiologist correctly identified a mass on the plaintiff’s colon as being highly suspicious for cancer. This finding was reported on the 2nd page of the radiology report and faxed to the urologist’s office, but the urologist never actually looked at the 2nd page of the report. As a result plaintiff’s colon cancer went undiagnosed for 19 months. He sued both the urologist and the radiologist. Plaintiff argued that the radiologist was negligent because he should have called to a urologist to directly report the significant and unexpected finding on the radiology study, and he should have followed up to ensure plaintiff’s cancer was diagnosed. This communication error lawsuit settled with radiologist contributing $2 million.
- 2017, Massachusetts $2,000,000 Settlement: A gastroenterologist sent a 43-year-old male patient to defendant radiologist for an ultrasound and CT scan due to troubling liver function tests. The radiologist correctly identified a potentially cancerous mass on the ultrasound and recommended a PET scan. The radiologist incorrectly interpreted the PET scan images as negative. Sometime later it was eventually discovered that the patient had liver cancer which by that point had become terminal. The patient’s family sued the radiologist alleging that he negligently misinterpreted the PET scan results causing a fatal delay in diagnosis of patient’s liver cancer. Claims against the radiologist were settled for $2 million.
- 2017, Massachusetts $1,000,000 Settlement: X-rays were performed on the chest and shoulders of a 62-year-old female plaintiff with 30-year smoking history and complaints of prolonged shoulder pain. Defendant radiologist read and interpreted the X-ray images and concluded that plaintiff’s lungs were “clear.” In fact, the plaintiff was suffering from lung cancer. Plaintiff’s expert testified that defendant radiologist misread the X-rays which revealed a cancerous mass in the lungs. As a result of this mistake, the plaintiff’s lung cancer progressed undiagnosed from Stage II to Stage IV with no chance of survival. This is not a case in Maryland because the victim was unlikely to fully recover from Stage II lung cancer.
- 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 the 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 the University of Maryland Medical Center [Learn more about malpractice cases against UMMC.]. After injuring her back and undergoing 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 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: This is a classic radiologist read the MRI wrong malpractice case with tragic consequences. 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 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.
- 2020, Virginia $500,000 Settlement: A woman received a high-pressure intravenous contrast to her left hand. The contrast spread throughout her dorsal soft tissues. The woman underwent an emergency fasciotomy. She subsequently underwent surgical debridement and irritation. The woman continued to experience nerve pain, tingling, burning, and limited mobility. She also sustained permanent hand and forearm scares. The woman alleged that the technician’s negligence caused her permanent injuries. She claimed the high-pressure contrast damaged her fragile caliber distal veins, causing it to spread throughout her hand and forearm. This case settled for $500,000.
- 2020, Pennsylvania $10,830,000 Verdict: A 41-year-old man underwent a back MRI. He was injected with gadolinium. The attending MRI technician noticed that the man’s breathing problems. They called for help. The ER medical director responded. They transferred the man to the ER. By that time, he had already suffered cardiac arrest. Thirty minutes later, the ER staff restarted the man’s heart. They diagnosed him with a significant brain injury. The man was left with short-term memory loss, executive functioning problems, and impulse control problems. He could no longer work as a project manager. The man’s father alleged that the hospital’s negligence caused his permanent injuries. He claimed they failed to properly train staff, require MRI rooms to be equipped with an emergency drug box, and timely respond to respiratory distress. A jury awarded $10,830,000.
- 2020, South Carolina: $675,000 Verdict: A 69-year-old woman suffered nausea, vomiting, dehydration, and bilateral leg muscle cramps. She presented to the emergency room. The woman was brought to the CT scan room. She experienced severe cramps while on the CT scanner table. The woman attempted to stand up. She fell to the floor. The woman suffered a left hip fracture. She underwent an open reduction internal fixation procedure. The woman now experienced difficulties with walking and other daily activities. She alleged that the radiology technician’s negligence caused her injuries. The woman claimed they failed to monitor her and prevent her fall. She received a 675,000 jury verdict.
- 2017, Iowa $400,000 Verdict: A woman presented to the hospital with chest pain. She underwent a CT scan. The emergency physician ordered the radiology technician to inject IV contrast dye. Before administration, the technician was informed that she was allergic to contrast dye. Nonetheless, she administered it to the woman. This caused the woman to suffer anaphylaxis, tachycardia, shortness of breath, and cardiac arrest. She was unresponsive for several minutes. The woman also developed post-traumatic stress disorder, anxiety, depression, nausea, hot flashes, short-term memory loss, and cognitive issues. She alleged negligence against the emergency physician and radiology technician. The woman claimed they negligently injected contrast dye despite being informed of her allergy. The hospital denied liability. They disputed whether the woman told the technician of her contrast dye allergy. A jury awarded the woman a $400,000 verdict.
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