Radiologists' Liability Issues

RADIOLOGISTS' LIABILITY ISSUES

Health Rights and Responsibilities SPRB11 Sec F

Instructor: Dr.:

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The clinical specialty of Radiology is based on the technology of acquiring medical images using a form of radiant energy. This form of imaging began with the discovery of x-rays by Wilhelm Conrad Roentgen in 1895. Immediately following Roentgen's discovery, medical practitioners began offering different forms of diagnostic x-ray techniques and x-ray therapy. Currently in the United States, approximately three hundred and fifty million radiographic procedures are performed at a cost of approximately thirty billion dollars annually. With these advances in the radiology there has been a great increase in professional liability claims. In fact there has been an average annual rate change of 3.9% in liability claims from 1986 to 1996 in the field (Socioeconomic Characteristics of Medical Practice, 1997/98).

Increasingly, the radiologist has become an integral member of the health care team. With an ever more direct involvement in patient care the Radiologist is at an increased likelihood of involvement in a malpractice suit as a defendant. The advancement of all radiographic modalities have made medical imaging an absolute must for patient diagnosis. Dramatic advances in technology have widened the horizons of radiology. These rapid advances, together with the rise in interventional procedures such as angioplasty (the repair of arteries using a balloon catheter), have contributed to the increased risk of being named as a defendant in a malpractice suit.

An example; a 66-year-old man was referred to a hospital radiology department for an air contrast lower gastrointestinal examination because of the recent onset of melena (black, "tarry" feces). After completing the fluoroscopic and spot-film portion of the examination, the radiologist instructed the radiology technologist to obtain overhead films. The radiologist left the fluoroscopy room, and the technologist proceeded to obtain the prescribed radiographs. During this process, the technologist asked the patient if he would be well enough to stand for the upright radiograph, and the patient answered in the affirmative. After positioning the patient against the wall-mounted Bucky grid, the technologist walked to the control panel to make the radiographic exposure. At this point, the patient suddenly collapsed and struck his head on the floor. The technologist quickly summoned assistance, and the patient, unconscious, was placed on a trauma stretcher. CT scans revealed that the patient had sustained a skull fracture and epidural hematoma. The patient was taken to the operating room, where a neurosurgeon evacuated the hematoma. After a four-day hospitalization, the patient was discharged. However, he continued to complain of headaches and dizziness.

Five months later, the patient filed a malpractice lawsuit against the radiologist, the radiology technologist, and the hospital. The lawsuit alleged that the patient had sustained a "serious