Breast Cancer, Mammography, and Malpractice Litigation: The Controversies Continue

Berlin, Leonard

doi:10.2214/ajr.180.5.1801229

Cited by 37 publications

(26 citation statements)

References 34 publications

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“…26 Several authors have focused on the issue of increasing medical malpractice claims regarding mammography in the United States. 10,11 One explanation for the high number of claims seems to be the public's high expectations of mammography performance. The limitations of screening are often poorly understood, which is probably due to campaigns encouraging women to undergo screening mammography and the media, which tend to emphasize only the benefits of screening.…”

Section: Discussionmentioning

confidence: 99%

Malpractice claims following screening mammography in The Netherlands

Smallenburg

Setz-Pels

Groenewoud

et al. 2012

Intl Journal of Cancer

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Although malpractice lawsuits are frequently related to a delayed breast cancer diagnosis in symptomatic patients, information on claims at European screening mammography programs is lacking. We determined the type and frequency of malpractice claims at a Dutch breast cancer screening region. We included all 85,274 women (351,009 screens) who underwent biennial screening mammography at a southern breast screening region in The Netherlands between 1997 and 2009. Two screening radiologists reviewed the screening mammograms of all screen detected cancers and interval cancers and determined whether the cancer had been missed at the previous screen or at the latest screen, respectively. We analyzed all correspondence between the screening organization, clinicians and screened women, and collected complaints and claims until September 2011. At review, 20.9% (308/1,475) of screen detected cancers and 24.3% (163/670) of interval cancers were considered to be missed at a previous screen. A total of 19 women (of which 2, 6 and 11 women had been screened between 1997 and 2001 (102,439 screens), 2001 and 2005 (114,740 screens) and 2005 and 2009 (133,830 screens), respectively) had contacted the screening organization for additional information about their screen detected cancer or interval cancer, but filed no claim. Three other women directly initiated an insurance claim for financial compensation of their interval cancer without previously having contacted the screening organization. We conclude that screening-related claims were rarely encountered, although many screen detected cancers and interval cancers had been missed at a previous screen. A small but increasing proportion of women sought additional information about their breast cancer from the screening organization.Many countries have introduced screening mammography programs with the aim to reduce breast cancer mortality. 1 Essential for reducing morbidity and mortality is the early detection of breast cancers, as a diagnostic delay lowers breast-conserving treatment options and worsens prognosis. 2,3 Unfortunately, a delayed diagnosis resulting from a missed cancer at screening is not rare. Certain cancers are just not visible at screening mammography, whereas others are misinterpreted or overlooked. 4,5 Interpretation of mammograms is one of the most difficult tasks in radiology and the sensitivity of screening mammography for breast cancer detection ranges from 70% to 80%. 6,7 Nevertheless, the public's expectations of the efficacy of screening mammography are high, and diagnostic errors can have major legal consequences for the screening radiologist.An Italian study observed, over a period of 12 years, a marked rise in malpractice claims related to diagnostic mammography in symptomatic women. 8 In the United States, a delay in breast cancer diagnosis is nowadays the most prevalent and the second most expensive condition resulting in malpractice lawsuits. 9,10 The most common defendant in these lawsuits is the interpreting radiologist and as a consequence the ...

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Section: Discussionmentioning

confidence: 99%

Malpractice claims following screening mammography in The Netherlands

Smallenburg

Setz-Pels

Groenewoud

et al. 2012

Intl Journal of Cancer

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“…[29][30][31][32][33][34] Although disclosing errors is difficult for any physician, radiologists face unique disclosure challenges, especially those who interpret mammograms. 35 Communicating effectively with patients following errors could enhance patient satisfaction and trust in future health care encounters. 36,37 Although it may seem counterintuitive, effective disclosure may also reduce the likelihood of malpractice claims.…”

Section: Organizational Culture Of Safetymentioning

confidence: 99%

Learning From Errors in Radiology: A Comprehensive Review

Pinto

Caranci

Romano

et al. 2012

Seminars in Ultrasound, CT and MRI

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An important goal of error analysis is to create processes aimed at reducing or preventing the occurrence of errors and minimizing the degree of harm. The discovery of any errors presents an opportunity to study the types that occur and to examine their sources and develop measures to prevent them from recurring. The development of an effective system for detecting and appropriately managing errors is essential to substantially attenuate their consequences. At this stage, the error analysis process identifies contributing factors to enable the implementation of concrete steps to prevent such errors from occurring in the future. Active and comprehensive management of errors and adverse events requires ongoing surveillance processes. Educational programs, morbidity and mortality meetings, and a comprehensive and respected root cause analysis process are also essential components of this comprehensive approach. To reduce the incidence of errors, health care providers must identify their causes, devise solutions, and measure the success of improvement efforts. Moreover, accurate measurements of the incidence of error, based on clear and consistent definitions, are essential prerequisites for effective action. Semin Ultrasound

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“…Moreover, one should always take into consideration the risk-benefit factor related to the procedures that are beneficial to patients, with respect to the basic ethical principles of medical practice, that is to say, the principle of beneficence, the principle of non-maleficence and the principle of justice (16) .…”

Section: Interpretation Of Conceptsmentioning

confidence: 99%

“…As an example, the failure to diagnose breast neoplasias was pointed out in 2002 by the report from the Physicians Insurers Association of America (PIAA -an organization comprising 26 medical professional liability insurance companies) as the most common and second most costly condition related to litigation between patients and physicians among the most diverse specialties, with radiologists being the most commonly sued specialists (16) .…”

Section: False-negative Diagnosismentioning

confidence: 99%

Responsabilidade civil do radiologista no diagnóstico do câncer de mama através do exame de mamografia

Oliveira¹,

Fonseca

Koch

2011

Radiol Bras

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O objetivo deste trabalho foi analisar a responsabilidade civil por erro médico no que tange, especificamente, à conduta do radiologista no diagnóstico do câncer através do exame mamográfico. Foram analisadas, para exemplificar, decisões judiciais com o objetivo de mostrar o entendimento dos tribunais nacionais, dentre eles, o Supremo Tribunal Federal, a quem compete revisar, em grau de recurso, as decisões judiciais que afrontam a Constituição Federal, bem como o Superior Tribunal de Justiça, que tem a competência de julgar em grau de recurso as decisões violadoras das leis federais. O material utilizado demonstra a visão dos tribunais acerca do tema objeto desta pesquisa, revelando as consequências do erro do médico radiologista e dos serviços de radiologia no âmbito do direito civil, que possui a indenização monetária como consequência da existência de responsabilidade civil. Ou seja, o dever de indenizar decorre da constatação da existência da responsabilidade civil. Assim, afastada a responsabilidade civil, fica afastado o dever de indenizar. Indenização não se confunde com a responsabilidade civil, esta é fundamento daquela.

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Breast Cancer, Mammography, and Malpractice Litigation: The Controversies Continue

Cited by 37 publications

References 34 publications

Malpractice claims following screening mammography in The Netherlands

Malpractice claims following screening mammography in The Netherlands

Learning From Errors in Radiology: A Comprehensive Review

Responsabilidade civil do radiologista no diagnóstico do câncer de mama através do exame de mamografia

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