ASTRO APEx
            <sup>®</sup>
            and RO-ILS™ are Applicable to Medical Malpractice in Radiation Oncology

Zaorsky, Nicholas G.; Ricco, Anthony; Churilla, Thomas M.; Horwitz, Eric M.; Den, Robert B.

doi:10.2217/fon-2016-0131

Cited by 4 publications

(7 citation statements)

References 17 publications

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“…The most common alleged error was improper performance, most frequently involving radiation therapy; this refers to claims where a physician’s action(s) resulted in a procedure being performed incorrectly 22 , for example misplaced prostate brachytherapy seeds resulting in rectal toxicity 15 or forgetting a spinal cord block, resulting in radiation myelitis 16 . Improper performance claims also carried the highest average indemnity payment among the most frequent alleged errors.…”

Section: Discussionmentioning

confidence: 99%

“…While advances in radiation techniques and technology can reduce radiation-related errors 27 , increased treatment complexity can introduce new pathways for error 5,31,33 . Errors that do result in clinical harm are typically linked to systematic flaws 34,35 , initiating a push toward quality standards and non-punitive reporting and incident learning 16,36–38 such as those from the American College of Radiology (ACR) 39 , American Society for Radiation Oncology (ASTRO)’s Target Safely campaign, and the Radiation Oncology Incident Learning System (RO-ILS) 36 . In addition to improving patient safety, these efforts may reduce malpractice risk for radiation oncologists.…”

Section: Discussionmentioning

confidence: 99%

“…Modern radiation oncology relies critically on image guidance and interpretation, which may increase the likelihood of misdiagnosis. For example, one case tried in court involved a radiation oncologist’s alleged failure to recognize a sigmoid colon cancer on a simulation CT for treating prostate cancer 16 . Another case involved failure to diagnose prostate cancer bone metastases 16 .…”

Section: Discussionmentioning

confidence: 99%

“…For example, one case tried in court involved a radiation oncologist’s alleged failure to recognize a sigmoid colon cancer on a simulation CT for treating prostate cancer 16 . Another case involved failure to diagnose prostate cancer bone metastases 16 . Radiation oncologists may also be implicated in misdiagnosis claims of incidental, non-oncologic conditions (such as appendicitis and aortic aneurysm in the current series).…”

Section: Discussionmentioning

confidence: 99%

“…Existing studies are limited to small descriptive reviews of malpractice claims from a single expert reviewer 14 and a series of prostate brachytherapy-associated legal claims 15 . Another recent report 16 looked only at radiation oncology cases adjudicated in court, which represent only 8% of all filed malpractice claims 17 .…”

Section: Introductionmentioning

confidence: 99%

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Nature of Medical Malpractice Claims Against Radiation Oncologists

Marshall

Tringale

Connor

et al. 2017

International Journal of Radiation Oncology*Biology*Physics

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Purpose/Objective(s) We examined characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. Methods and Materials Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression. Results There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38 million in indemnity payments. The most common alleged errors included: ‘improper performance’ (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity); ‘errors in diagnosis’ (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity); and, ‘no medical misadventure’ (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. ‘Improper performance’ was the primary alleged error associated with injury resulting in death. Compared to claims involving death, major temporary injury (OR 2.8, 95% CI 1.29–5.85, P=0.009), significant permanent injury (OR 3.1, 1.48–6.46, P =0.003) and major permanent injury (OR 5.5, 1.89–16.15, P =0.002) had higher likelihood of a claim resulting in indemnity payment. Conclusions Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims against radiation oncologists may help direct efforts to improve quality of care and minimize the risk of being sued.

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Section: Discussionmentioning

confidence: 99%