American Roentgen Ray Society

 

Author: American Roentgen Ray Society

Title of Article: Malpractice and radiologists in Cook County, IL: trends in 20 years of litigation

Name of the Journal: American Journal of Roentgenology, Vol 165, 781-788.

Brief summary of the main points in the article

The article highlights the reports found in the prevalence and nature of all the relevant malpractice litigation that were associated with Radiology in a span of about 20 years. It identifies the trends involved in all the lawsuits reported. It recognizes the medico-legal risks that are related with radiology, its risk management procedures and ways of minimizing both the exposure and how it can be advanced to improve the welfare of the patients (American Roentgen Ray Society, 1995). The article also highlights the malpractice related policies attributable to the significant impacts related on the patients negligence caused by the doctors and the healthcare firms, their damage and the outcome on the patient’s health.

Introduction

In the last two decades, the medical sector has been on the limelight due to its malpractices that have caused much harm to the patients in our healthcare services center. Medical malpractices are among the common emerging trends in the health sector, as they have become part of daily undertakings by the health sector. This has resulted to the medical malpractice attorneys, the relevant laws and policies and other related fields to consider it as they are looking for ways of handling it. The physicians are called upon to consider the absurdity in the health sector and focus on ways of dealing with the unethical issues involved in the program. The article Malpractice and radiologists in Cook County, IL: trends in 20 years of litigation highlights the prevalence and the nature of malpractices litigation involved in radiology in the last two decades in America, its causes, effects and the final relation to the lawsuits, and the impacts of the same on doctors’ profile (American Roentgen Ray Society, 1995). Eliminating malpractices and litigations in radiology is imperative towards the reclamation of the career’s credibility, image and doctors profiles.

Discussion

Prevalence in medical malpractices have been the point of argument as patients and other involved parties have ventured into ways that reduce the ever increasing cases in our daily life practices, infusing negative reactions to the career. Malpractice can be defined as the professional error made by an individual as it is said to be the error made by a doctor during the diagnosis and treatment process of a patient. Over time, the failure of physicians to react according to calls made by patients has resulted in the option of involving the legal law system that comprises of the court system in solving the malpractices. Subsequently, there has been an increase in the demand for no fault systems to advocate for the process of doing away with the medical malpractices in the country.

The causes of the litigations were identified through the research objective aimed at identifying of the trends involved law suits reports as the main impetus behind the careers deepening. This was achieved through the recording of all rationales given by affected radiology individuals in resorting to court practices. In particular, the study involved all malpractices lawsuits that were reported to the authority against the physicians in Chicago in 1st January 1975 to 31st December, 1994 (American Roentgen Ray Society, 1995). The research recorded about 11% as the procedure involved radiologic procedures, and radiologists. The researchers used the data collected in analyzing by categorizing it into relative figures in relation to the radiology suits reported. For enhanced analysis, the rationales were fitted into six broad categories in accordance to the association levels. They included:

  • Slip-and-fall stage
  • Radiation oncology
  • Failure in ordering radiologic examination
  • Complications involved to patients
  • Missed diagnoses by physicians
  • Miscellaneous information

Tangible statistical figures ascertained the prevalence of the malpractices lawsuits identified as evidenced by a rise in radiology cases to the year 1985. The inaction of tort reforms measures in Illinois led to a decrease in the cases afterwards as they awarded high compensation to affected patients ranging between five hundred thousand dollars to one million dollars towards covering the inconveniences and other effects. With the medical practitioners dreading the huge financial liability, it led to an enhancement of service delivery and thereby reducing the inaccuracy levels. After the enactment, the figures increased with an annual average in its percentage with a constant in the percentages of radiology between 10-16 percent annually. Berlin (2003) in the article Radiologic Malpractice Litigation: A View of the Past, a Gaze at the Present, a Glimpse of the Future observes that radiology law suit cases have fluctuated in the last two decades as the research indicates a decrease in the slip-and-fall stage, the radiation oncology and miscellaneous. However, there has been an increase in failure in ordering radiologic examination, missed diagnoses and failure in ordering radiologic examination in the period. The law suit cases involving missed diagnoses accounts for the prime group of radiology cases in the study as over the period it has risen from 35 percent to 45 percent in its totals.

A skewed relationship was noted within the identified trends as related to the causes of the malpractices. During the study with breast cancer, related cases noted, as the highest as there have been numerous lawsuits harms reported. Angiography was ranked as the largest case in the group though failures to order for radiologic tests did show high changes in the 20 years of study. The statistics indicated a growth of 21 percent between the year’s 1975- 1979 to 30 percent from 1991 to 1994 during the study (American Roentgen Ray Society, 1995). This was attributed to the rise in claims involving mammography, magnetic resonance, computed tomography, angiography and imaging instances. Growth in failure-to-order had a significant in the health sector as the data aids in formulating policies and proposals to control the common usage of radiologic services.

The most worrying pattern with regard to malpractices amongst radiologists is the fact that the problem persists to the present as noted by Haplin (2009) in the article Medico-legal claims against English radiologists: 1995-2006, a methodical analysis that covers the periods 1995 to 2006. The persistence infers a high level of ignorance towards the issue by the radiology practitioners or lack of earnestness in the elimination of the problem. A succinct appraisal of the situation reveals that malpractices are majorly noted within three areas that Haplin (2009) categorizes as perception inaccuracies, execution mistakes and intention miscalculations, with the former comprising of the most notable malpractices. Further, Haplin (2009) holds the view that perception inaccuracies are the weightiest of the three as it reflects inadequate knowledge towards the analysis and recognition of an abnormality, as well as the inability to accord a precise opinion with regard to the issue.

Legal complaints towards the problem of inaccurate perceptions are highly complex with the most outstanding constraint being the fact that the radiology practice is limited in terms of diagnosis attributed to patterns of information processing. This viewpoint has been advanced upon various observations that have noted divergences towards working on similar cases for diagnostic purposes. Although the radiologists may offer the same results, the majority of instances tend to be slightly dissimilar; the step processes followed towards the final realization are also very different. In fact, scholars have detected that at least twenty percent of all radiologists tend to have varying reports on diagnoses on every instance that they have to review a previously attempted case (Haplin, 2009). Individual dissimilarities in terms of the reports actually differ with up to a fifth of the initial observations and thus bearing the ability to reverse the wrong diagnoses by thirty percent.

Haplin’s viewpoints offer a very balanced analysis towards the aforementioned issue within the radiology practice by even challenging the idea as to whether malpractices exist. It is a rather inflated view that a radiology practitioner would choose to be hasty and ignorant within their duties as this would just be plainly inhumane. Again, such misdiagnoses have been prevalent in a few practices like the detection of breast cancers as opposed to other ailment like lung cancer despite the fast that the latter condition affects a larger populace. Note that, all radiologists bear the same credentials and employ identical technologies in the detection and treatment for the ailments (Haplin, 2009). Of inference therefore is that radiologists within the breast cancer practice are either unintelligent or that the detection process is rather difficult as that employed in lung cancer.

Milstein (2008) in the article Research Malpractice and the Issue of Incidental Findings assists with the issue of unintelligence through an investigation conducted on neuroradiology practitioners. The analysis employed two specific aspects, with the initial centering on the divergence element across various radiologists as concerned with the same examinations. The neuroradiology practitioners were dealing with an examination of human brains with variations noted by the level of incidental findings being noted at eighty-two percent of the participants. The second aspect primarily dealt with academic credentials as indicators for the unintelligence element revealing that amongst the participants evidencing the divergences, forty-one percent comprised of radiology learners whereas twenty-one percent were radiology therapists pursuing post-doctoral programs or actively involved within medical institutions (Milstein, 2008). These results therefore disrepute the view that radiology malpractices originate from unintelligence instances. Subsequently, this leaves the standpoint that such instances are reflective of intricacies noted within the human anatomy, especially on sensitive areas such as the mammary gland and brain.

Milstein (2008) further notes that in addition to the intricacy element, the monetary element has enhanced the issue of divergences across radiology practice as noted by the Institutional Review Board (IRB) views on the malpractice issue based on the neuroradiology investigation. Among the presented review cases that the participants interacted with, only twenty-two percent mandated procedural diagnosis with the rest being left to the participants’ discretion. The similarity level was thereby noted as thirteen percent, with sixty-nine percent being assigned the suspicious state for advanced examinations and only eighteen percent of the cases lacked any form of investigation (Milstein, 2008). The reason attributable to the deferred diagnoses was the financial limitation acting as a constraint for further investigations towards a clearer determination of the cases. This should not however be confused to denote that all malpractices cases are caused by intricacy elements since credible ignorance instances have also been noted within the practice.

The intricate nature of litigations dictates that it is difficult to prove a case of malpractice in the medical sector. Latest statistics show that about two thirds of all the reported cases end up in favor of the defendant. In this form of association, Sanbar and the American College of Legal Medicine (2004) note that it is upon the attorney to find evidence for negligence as alleged on the caregiver’s side. It is normally difficult to find the evidence and as the existence of malpractice in insurance policies clearly show that both the healthcare providers and doctors are not keen on taking risks. Most of the cases of malpractices occur during a patients stay in the hospital when undergoing risky procedures and treatments. Therefore, hospitals are held responsible for any actions that are undertaken by its employees.

A good instance is that noted by in Starr’s article (2004) Nonspecific symptoms lead to missed diagnosis comprising of a six-month review by a long-practicing radiologist that failed to identify a gastrointestinal cancer ailment within a patient leading to his demise. The family of the demised individual employed litigation for the occurrence and the radiologist was afforded thirty-eight percent liabilities for the demise with the rest accounted to the health institution. The monetary penalty awarded for the same amounted to two million two hundred thousand dollars split in accordance to the liability percentages to both the health care establishment and the radiologist.

Final relations to lawsuits have revealed that malpractice is not only what the doctor might have done, it is also, what he did not do in accordance to the National Medical Association (Walton, 2004). Let us look at the Polk County Florida case where the family of a thirty one year old mother and wife was rewarded with $1.75 million pounds. This is because of an undiagnosed heart disease. When the case was highlighted, the court did not find the cause where the doctor misdiagnosed the woman, additionally made a mistake during the surgery or injured the patient. All that can be said is that the doctor failed to diagnose a heart condition that could have lead to the death of the woman in picture. It was later on determined that the doctor exhibited an extent of negligence in the diagnosis process. The case was ruled favoring the plaintiff because this is something that the doctor could have avoided (American Roentgen Ray Society, 1995).

Malpractice cases in the radiology practice have had mutual effects to both the practitioners as well as the patients in terms of bad profile imaging devastating health issues respectively. These incidences of malpractices by doctors have lead to loss of lives as the wrong treatment being administered to the patients with other patients having surgical equipment left in their bodies after an operation, and other such cases have given rise to many deaths. The malpractices errors and issues remain at a steady pace of twelve percent on a yearly basis hence reducing the accuracy level with the same proportion. Hirschfield (1990) in the article Practice parameters and the malpractice liability of physicians notes that such levels to the doctors’ profile serves as a very high proportion affecting the profession adversely with the inaccuracy bit. The image spread is rather high as it also tends to have the same effect on potential radiologists first by acting as an inhibitor within career enhancement and secondly within the issue of remuneration. As more and more of the practitioners are applied to such litigations, it will also have a bad image on the health organization management docket as the licensure controllers by reflecting incompetence within the department.

Conclusion

It goes without say that something needs to be done soon if not soon, now to combat this bad behavior among the doctors, health practitioners and givers. Additionally, laws and regulations should be implemented to protect the public from further injuries and deaths as this will help in curbing the increasing cases of malpractices among the health providers as noted by Garnick, Hendriks and Brennan (1991) in the article Can Practice Guidelines Reduce the Number and Costs of Malpractice Claims? The insurance firms handling the lawsuit cases are also called upon to be on the watch out in handling all the malpractice health cases. Proper handling will give way for persecution of doctors identified with malpractices in the health sector. The introduction of tort reforms in Illinois gave way for decrease in the malpractice litigation to some extent from 1985 to 1995 as indicated by the research.

References

American Roentgen Ray Society. (1995). Malpractice and radiologists in Cook County, IL: trends in 20 years of litigation. American Journal of Roentgenology, 165, 781-788.

Berlin, L. (2003). Radiologic Malpractice Litigation: A View of the Past, a Gaze at the Present, a Glimpse of the Future. American Journal of Roentgenology, 181(6), 1481-1486.

Garnick, D. W., Hendriks, A. M., & Brennan, T. A. (1991). Can practice guidelines reduce the number and costs of malpractice claims? Journal of the American Medical Association, 266, 2856-2860.

Haplin, S. F. S. (2009). Medico-legal claims against English radiologists: 1995-2006. The British Journal of Radiology, 82(984), 982-988.

Hirschfield, E. B. (1990). Practice parameters and the malpractice liability of physicians. Journal of the American Medical Association, 263, 1556-1562.

Milstein, A. C. (2008). Research Malpractice and the Issue of Incidental Findings. Journal of Law, Medicine & Ethics, 36(2), 356-360.

Sanbar, S., & American College of Legal Medicine. (2004). Legal medicine. Philadelphia, PA: Mosby, cop.

Starr, D. S. (2004). Nonspecific symptoms lead to missed diagnosis. Cortlandt Forum, 17(6), 87-88.

Walton, T. M. (2004). Principles of Radiological Health and Safety. Journal of the National Medical Association, 96(1), 122.

 

Use the order calculator below and get started! Contact our live support team for any assistance or inquiry.

[order_calculator]