Page 44 - 2022 Risk Basics - Radiology

SVMIC Risk Basics: Radiology

Key Challenge #3: Diagnostic Errors

Diagnostic error in medicine is a major cause of patient harm, with the

rate of missed, incorrect, or delayed diagnoses estimated to be as high
as 10-15 percent. Due to the highly subjective nature of radiographic

interpretation, the rate is higher for radiology. As we noted in this course’s
“By the Numbers” section, errors in diagnosis are the most common

cause of malpractice suits against radiologists, by far.

Because more than one billion radiographic examinations are performed

worldwide annually, a 4 percent error rate translates into approximately

forty million interpretive errors per year.

Fortunately, most errors are minor or, if significant, are found and

corrected quickly enough to avoid serious harm to the patient. Yet, many
interpretation errors do result in harm to patients and also result in

malpractice lawsuits against and indemnity payments made on behalf of
radiologists. Here is one example.

C A S E S T U DY

A 58-year-old male was transported to the emergency department
after flipping a riding lawnmower over on top of himself. The patient

had thoracic x-rays read by the radiologist as a compression

fracture at T-10 (which later was discovered to be an injury at T-9,
not T-10). Nothing else was noted. The patient was discharged but
returned to the ED two days later with complaints of dehydration,

inability to void, decreased responsiveness, renal failure, and

increased enzymes. A CT of the abdomen was ordered, and the
same radiologist interpreted the scan as “unremarkable”. An MRI
was ordered a couple of days later revealing a burst fracture at T-9

with spinal cord involvement. The patient has permanent motor

and neuro deficits.

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