Ethical problems in radiology: medical error and disclosure

Magnavita, Nicola; Magnavita, Giulia; Fileni, Adriano; Bergamaschi, Antonio

doi:10.1007/s11547-009-0445-z

Cited by 15 publications

(15 citation statements)

References 34 publications

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“…According to epidemiological data in Italy, diagnostic errors are at the basis of 60 % of claims against radiologists [17, 18]. A correct reading of MRI scans without missing clinically important IF may prevent not only potentially severe consequences for the patient but also medico-legal implications for the radiologist.…”

Section: Discussionmentioning

confidence: 99%

Extra-spinal incidental findings at lumbar spine MRI in the general population: a large cohort study

et al. 2013

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ObjectiveTo determine the prevalence of clinically and non-clinically relevant extra-spinal incidental findings (IF) in patients undergoing magnetic resonance imaging (MRI) of the lumbar spine and to evaluate the rate of undetected findings in archived radiological reports.MethodsA retrospective search of patients undergoing lumbar spine MRI from January 2006 to December 2010 was conducted. By means of randomisation, we retrospectively reviewed 3,000 lumbar spine MRI examinations. Extra-spinal abnormalities were classified according to a modified CT Colonography Reporting and Data System (C-RADS). We retrospectively compared our structured approach with the archived MRI reports as it regarded the detection of extra-spinal IF to estimate non-detection rates.ResultsBy means of the structured approach used, extra-spinal findings were detected in 2,060 (68.6 %) of the 3,000 lumbar spine MRI examinations; 362 (17.6 %) patients had indeterminate or clinically important findings (E3 and E4) requiring clinical correlation or further evaluation. After review of the original archived radiological reports, potentially important C-RADS E3 and E4 extra-spinal IF were respectively reported in 47 of the 265 (17.7 %) and in 8 of 74 (10.8 %) patients.ConclusionsOur study shows that incidental extra-spinal findings at conventional lumbar spine MRI are common but underestimated in radiological reports.

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Section: Discussionmentioning

confidence: 99%

Extra-spinal incidental findings at lumbar spine MRI in the general population: a large cohort study

et al. 2013

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“…Currently, physicians and dentists have increased responsibilities regarding the request for, performance and interpretation of imaging exams. Considering the increase of claims against these professionals, studies conducted in the United States, United Kingdom, Australia and Italy warn about the legal implications of errors in radiology, and suggest solutions to minimize the number of faults and their consequences 2,4-6, [24][25][26] . Lacking information about this reality in Brazil, the aim of this study was to analyze court decisions covering imaging exams in medicine and dentistry.…”

Section: Discussionmentioning

confidence: 99%

Civil liability related to imaging exams in Brazil

Fontana¹,

Liedke²,

Fontoura³

et al. 2015

Braz. J. Oral Sci.

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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.

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“…But honest, open and comprehensive communication surely implies the disclosure of procedural (non diagnostic) and diagnostic errors too [11]. As with adverse events which does not necessarily implies a personal medical liability, procedural and diagnostic errors, which for several branches of medicine has surpassed all other error categories, should be promptly disclosed to patients [12]. …”

Section: Discussionmentioning

confidence: 99%

Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics

Turillazzi

Neri

2014

BMC Med Ethics

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BackgroundThe Italian code of medical deontology recently approved stipulates that physicians have the duty to inform the patient of each unwanted event and its causes, and to identify, report and evaluate adverse events and errors. Thus the obligation to supply information continues to widen, in some way extending beyond the doctor-patient relationship to become an essential tool for improving the quality of professional services.DiscussionThe new deontological precepts intersect two areas in which the figure of the physician is paramount. On the one hand is the need for maximum integrity towards the patient, in the name of the doctor’s own, and the other’s (the patient’s) dignity and liberty; on the other is the physician’s developing role in the strategies of the health system to achieve efficacy, quality, reliability and efficiency, to reduce errors and adverse events and to manage clinical risk.SummaryIn Italy, due to guidelines issued by the Ministry of Health and to the new code of medical deontology, the role of physicians becomes a part of a complex strategy of risk management based on a system focused approach in which increasing transparency regarding adverse outcomes and full disclosure of health- related negative events represent a key factor.

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Ethical problems in radiology: medical error and disclosure

Cited by 15 publications

References 34 publications

Extra-spinal incidental findings at lumbar spine MRI in the general population: a large cohort study

Extra-spinal incidental findings at lumbar spine MRI in the general population: a large cohort study

Civil liability related to imaging exams in Brazil

Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics

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