Page 45 - 2022 Risk Basics - Radiology

SVMIC Risk Basics: Radiology

The abdominal CT was ordered to “rule out a retroperitoneal bleed”;

therefore, the radiologist stated he did not interpret the scan for
bony pathology. Multiple defense experts were consulted, and each

concluded the burst fractures were clearly evident on the abdominal
CT. The radiologist grossly under-interpreted the CT scan and

should have identified the fractures along with its severity in the
report.

Adhering to the “control the things you can control” philosophy, it is

important that the radiologist understands the roles that workload
and fatigue contribute to diagnostic errors. As medical reimbursement

continues to trend downward, radiologists attempt to compensate by
undertaking additional responsibilities and increasing organizational

productivity. The increased workload, rising quality expectations, poor
communication, cognitive biases, and imperfect information systems

serve as major sources of fatigue, often leading to diagnostic errors.
Despite continuously evolving technology refinement and development,

the current medical imaging system has developed as a one-size-fits-
all model with relative inflexibility, which can impede workflow and

productivity as well as cause end-user fatigue. As imaging volume and
complexity continue to grow over time, the impact of visual fatigue on

diagnostic accuracy is becoming increasingly important. The following
case illustrates this issue well.

C A S E S T U DY

A 64-year-old male presented to his PCP with a cough and
difficulty breathing. A chest x-ray was ordered and interpreted by

the radiologist as right-lower lobe pneumonia.

The patient returned to his PCP seven months later with complaints

of left shoulder pain/tenderness. A left shoulder x-ray was read by

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