A 12-year follow-up study of malpractice claims against radiologists in Italy

Abstract

The risk of medical malpractice litigation for Italian radiologists is by now comparable to that for American radiologists. Strict adherence to radiological standards may be a means of reducing the risk of legal action and obviating litigation.

Medical error: General term and its overview in radiology

“…The United States has the highest data in this area and they indicate that in a five-year level 40% of radiologists have been sued (19,24). It is necessary to pay attention to this area, first of all by educating radiologists and radiology technicians and also the patients.…”

“…In 66.7% of cases, the reason was the wrong diagnosis; in 10.3% mistakes in technique and procedure (for example, administration of contrast), half of which is from the field of interventional radiology (risk is 47.3 per 1000 procedures) (19,20). The most common mistakes were made on "the skeletal system (44.5%), breasts (25.8%), chest (11.4%) and abdomen (8.3%)" (19). The main causes for suits in the field of interventional radiology were: vascular complications in 43.9% of subjects, complications after needle biopsy in 14.3%.…”

Critical issues in radiology requests and reports

“…The latter, even though generally adequate to allow for a correct diagnostic classification, sometimes appear at risk of ambiguous and nonunivocal interpretation. This leads to a possible negative impact on the patient's health and a secondary risk of litigation or malpractice charges against the radiologist [6], the incidence of which has recently become almost comparable with that in the United States, Fondamentale è dunque una precisa ed adeguata modalità di comunicazione universale tra le varie figure professionali che orbitano attorno alla richiesta, alla stesura e all'interpretazione di tale atto [4]; esso rappresenta una prestazione professionale che, pur contraddistinta da una serie di procedure operative integrate tra loro, con specifiche finalità diagnostico/interventistiche, riconosce, quali momenti fondamentali, quello della richiesta e del referto, spesso comportanti problematiche e difficoltà sia nell'interpretazione dei dati correlati al quesito diagnostico sia nella compilazione della risposta scritta. La causa prevalente di tali difficoltà è spesso identificabile in una carenza di precise indicazioni metodologiche, con conseguente disomogeneità nella tipologia delle richieste e contestuale notevole variabilità nelle risposte [5]; quest'ultime, sebbene generalmente idonee a consentire un corretto inquadramento diagnostico, appaiono talora a rischio di ambigua e non univoca interpretazione dei dati, con possibili ripercussioni negative per la salute del paziente e secondari rischi di contenzioso od accuse per malpractice [6], la cui incidenza ha assunto, negli ultimi anni, frequenza quasi paragonabile a quella degli Stati Uniti, dove il numero di denunce è secondo solo a quello delle discipline chirurgiche [7].…”

Analysis of malpractice claims in mammography: a complex issue

“…To account for the fact that claims for presumed diagnostic errors are lodged after a variable time interval, at times close to the expiry of the prescriptive period for compensation (10 years from the event), we estimated the number of insurance claims expected to be filed until the end of the prescriptive period by using a method described in a previous paper [1]. First, starting from the assumption that the tendency to sue physicians is constant over time, we assumed that the trend of claims between 1993 and 1995, once the effect of late claims was eliminated, expressed the constant trend of claims in the cohort.…”

“…From a study of a cohort of radiologists comprising more than half those enrolled in the Italian Society of Medical Radiology (SIRM), it emerges that failure to diagnose breast cancer is the most frequent cause of medicolegal litigation, which has considerably increased over the past 12 years [1]. Starting from an analysis of epidemiological data concerning malpractice liability claims against radiologists, we sought to examine error as an "adverse event" in breast cancer diagnostics with a view to uncovering critical areas and identifying possible strategies to control the malpractice risk connected to the performance of mammography.…”