Page 47 - Diagnostic Radiology - Interpreting the Risks Part One

SVMIC Diagnostic Radiology: Interpreting the Risks

At SVMIC, we are typically viewing care after a claim has been

asserted or a threat has been made. Under these circumstances
(after-the-fact), referring providers seem to always take the

position that they not only preferred, but also expected, a phone
call from the radiologist. This is often true even if the finding was

not an emergent or unexpected finding. See the following case
example.

CASE STUDY

A 57-year-old male smoker (2-3 packs per day for 40 years)
presented to the emergency department with chest pain

radiating to the left arm. Chest pain protocol was ordered
along with a CT of the chest to rule out PE. The CT was

interpreted by the radiologist as negative for pulmonary
embolism. The report did mention that there was a 7-10mm

nodule present in the left-upper lobe which should either
have had a follow-up scan in four months or a PET CT

for further evaluation, but the radiologist never called the
referring physician. Fourteen months later, the patient

complained of left shoulder pain and an MRI of the left
shoulder was obtained, which showed a lesion suspicious

for metastatic disease. A CT of chest, abdomen, and
pelvis showed multiple lesions within the bone and liver

metastasis. The patient died and a wrongful death lawsuit
was filed.

The claim against the radiologist included that he failed

to call with “unexpected” findings (instead of suspicious),
which is a violation of policy. Weak points included that

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