Civil liability related to imaging exams in Brazil

Abstract

Aim: To analyze all court lawsuits in Brazil in relation to civil liability involving radiographic and tomographic images up to February 2014. Methods: All Brazilian courts were surveyed for "civil liability," "error," "radiology," "radiography," and "tomography," returning 3923 second-instance lawsuits. Out of them were excluded labor legislation, health insurance coverage of radiological examinations, and criminal liability cases and 359 were selected. Compliance with expert reports, involvement of imaging exams, the defendant professional, the reasons of claims and convictions, and indemnity were evaluated. Results: Of the 359 selected lawsuits, physicians were defendants in 71%, radiologist physicians in 10.6% and dentists in 18.4%. The prevalence of physicians found liable was related to the lack or delay in requesting the imaging exams (49.6%), and among radiologist physicians, misdiagnosis (47.1%). Considering the dentists, imaging exams had mostly an indirect involvement, and failure of the proposed treatment (73.8%) was the most prevalent cause of dentists found liable; no radiologist was sued. Regarding indemnity, 50% of lawsuits resulted in compensation up to R$ 20,000 (US$ 8,583). Conclusions: Misdiagnosis was the main cause of claims and radiologists were found liable. The medical field showed the largest absolute number of claims and physicians were found liable, but the highest proportion was directed to dentists.

The Adoption and usage of cone beam computed tomography and panoramic radiography machines across Australia

“…Similar litigation cases are noted internationally, where inadequate prescription of diagnostic imaging in areas such as oral surgery, implant placement and orthodontic treatment was claimed to have contributed to harm. 75,76 The above-mentioned evidence supports strongly the correct use of radiographic examinations by dental practitioners wherever relevant and applicable. In a report by Brown and Monsour, 5 there is some evidence indicating that within the field of invasive oral surgery, there has been a preference of CBCT to PR among Australian practitioners in recent years.…”

“…76,78 Overseas studies have reported misdiagnosis as being responsible for the majority of litigation cases involving radiologists. 75 Incidental radiographic findings for the dento-maxillofacial region have shown as high as 93.42% for non-dental pathology. 79 However, there is generally a lack of consistency in the literature accounting for incidental findings, largely due to different study designs used.…”