Originally from:
Preparing And Winning Medical Negligence Cases - 3rd Edition - Hardcover
Preparing and Winning Medical Negligence Cases- 3rd Edition - Electronic
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RADIOLOGY
by Leonard Berlin
§ 9.01 Introduction
[1] Historical Perspective
In 1794, the United States’ first medical malpractice lawsuit was adjudicated by a Connecticut court. The husband of a woman who had died as a result of surgery sued the physician for operating in “the most unskillful, ignorant, and cruel manner, contrary to all the well-known rules and principles of practice,” and violating “his promise to the plaintiff to perform said operation skillfully and with safety to his wife.” The lawsuit, the primary allegation of which was breach of contract, was won by the plaintiff. The jury found the physician liable and awarded damages of 40 English pounds.
[2] Standard of Care for Physicians: Nineteenth Century Court Decisions
One of the earliest State Supreme Court decisions in the United States setting forth the standard of care for physicians was rendered in 1832, again in Connecticut. A physician was accused of negligence for “unskillfully and carelessly making an incision into the plaintiff’s arm to insert [smallpox] vaccine, such that she suffered great pain and her arm was irreparably injured.” The jury found in favor of the plaintiff, and the defendant-physician appealed. Although the Connecticut Supreme Court upheld the jury verdict, its eloquent commentary regarding physicians seems as relevant today as it was 176 years ago.
A physician and surgeon, in the performance of his professional duties, is liable for injuries resulting from the want of ordinary diligence, care and skill. Physicians never warrant their work. They make no promise, except to do as well as they can, and as well as they know how to do. “Ordinary” means usual, common. The difference between a want of ordinary or useful skill and gross negligence is essential and important. To say that a physician did not perform a certain operation with ordinary skill conveys a very different idea from the assertion that he performs it with gross negligence.
CHAPTER 9
RADIOLOGY
Leonard Berlin, MD, FACR
SYNOPSIS
§ 9.01 Introduction
[1] Historical Perspective
[2] Standard of Care for Physicians: Nineteenth Century Court Decisions
[3] Radiology Is Introduced into the Courtroom
[4] Radiological Malpractice: 1975–Present
[5] General Medical Malpractice Litigation : 1970s–2008
§ 9.02 Radiological Errors
[1] Early Research
[2] Prevalence of Radiographic Errors
[3] Errors in Clinical Medicine
[4] Error Rate Defined
[5] Errors and Their Impact on Patient Care
[6] Computer-Assisted Detection (CAD)
[7] Causes of Errors
[8] Errors versus Negligence
[9] Malpractice Defined
[10] A More Liberal View of How Malpractice Is Defined: The Wisconsin
Court
[11] Defending Radiographic Misses: Hindsight and Outcome Biases
[12] Errors and Malpractice: Pubic Perceptions
[13] The Inescapable Realities of Radiologic Practice
§ 9.03 Communication
[1] Comparing Current Radiological Exams with Those Obtained
Previously: The Alliterative Error
[2] Direct Communication of Radiologic Findings to Referring Physicians:
The Courts’ Perspective
[3] American College of Radiology Practice Guidelines and Standards
[4] Do ACR Practice Guidelines Dictate the Standard of Care?
[5] Practice Guidelines (PG): The Disclaimer
[6] Should Radiologists Communicate Results of Radiologic Studies
Directly to the Patient?
[7] The Courts Extend the Radiologist’s Duty to Communicate to the
Referring Physician
[8] The Courts Extend the Radiologist’s Duty to Communicate to the Patient
[9] The Arizona Court Decision —and Its Far-reaching Implications
[10] The Mammography Quality Standards Act (MQSA) and Its Impact on
Malpractice Litigation and Referring Physicians
[11] The Prevalence and Causes of Communication Problems
[12] The Trend toward Communication of Results from Radiologist Directly
to Patient
§ 9.04 Mammography
[1] Breast Cancer, Mammography, and Malpractice
[2] Perceptions and Misperceptions
[3] The Perception of High Risk of Developing and Dying from Breast
Cancer
[4] The Perception of Perfection
[5] The Perception That Early Detection by Mammography Will Cure
Breast Cancer
[6] Additional Controversies Surrounding Efficiency of Mammography
[7] Defending Malpractice Lawsuits Alleging Delay in Diagnosis of Breast
Cancer
[8] The Perception versus Reality Dilemma
[9] The Delay in Breast Cancer Diagnosis Dilemma
[10] Delay in Diagnosis of Breast Cancer versus Patient Injury
[11] Has Mammography Been Overpromoted?
[12] Continuing Controversies: Breast Cancer and Mammography
[13] The Public Must Be Better Educated about Breast Cancer and
Mammography
[14] Screening versus Diagnostic Mammography
§ 9.05 Guidelines and Standards
[1] The Expert Witness and Professional Practice Guidelines
§ 9.06 Harmful Effects of Exposure to X-Radiation
[1] Burns and Other Injuries Resulting from Exposure to X-Radiation
[2] The Advent of Interventional Radiology
[3] Minimizing Radiation Exposure
[4] Radioactive Iodine and the Pregnant Patient
[5] Minimizing Radiation Exposure from Radiopharmaceuticals in
Pregnant Patients
§ 9.07 Total Body CT Screening
[1] Potential Malpractice Pitfalls of Screening
[2] The False Negative
[3] The John Ritter Lawsuit
[4] Overdiagnosis
[5] Radiation Exposure
[6] Abandoning a Patient
[7] The Duty to Disclose and Informed Consent in Screening
[8] The Ethics of Screening
[9] Contrast Media and CT Screening
[10] CT Screening: Present Status and Future Directions
Leonard Berlin, MD, FACR. Former Radiology Chairman at Rush North Shore Medical Center, Skokie IL; current Vice-Chairman at North Shore University Health System, Skokie, IL Hospital; Professor of Radiology at Rush University Medical College in Chicago; Past President of the Illinois Radiologic Society and the Chicago Radiological Society; Consultant to malpractice insurance companies; past Chairman of the American College of Radiology’s Ethics Committee, and current Chairman of the Radiological Society of North America’s Professionalism Committee; Awarded the Gold Medals for distinguished service to Radiology by both the American Roentgen Ray Society and the Chicago Radiological Society; Has presented more than 300 lectures nationally and internationally on risk management; Author of Malpractice Issues in Radiology and of more than 300 scientific articles.
