Breast Cancer, Lung Cancer, Failure to Appreciate Imaging
Failure to diagnose cancer from x-ray is a common problem. It gives rise
to stunning results, costs lives, increases medical care costs, and it
At Domina Law Group pc llo, our experience with radiology malpractice includes:
- Radiology malpractice – failure to diagnose breast cancer;
- Radiology malpractice – failure to follow cysts and signs in breast
screening x rays from a baseline year, and from year to year;
- Failure to refer the patient;
- Failure to identify the need for additional testing;
- Failure to diagnose lung cancer;
- Failure to identify suspicious lesions, images or masses for further study,
resulting in delayed lung cancer and breast cancer diagnosis.
What does the recent study disclose?
Professional negligence in radiology often includes:
- The failure to read the entire x-ray, with excessive focus on a suspect
area, and simply overlooking other significant medical evidence;
- Failure to require prompt mammography upon presentation of a breast lump;
- Failure to prevent metastasis of cancers sufficiently localized to permit
surgical removal if prompt findings are made;
- Lung cancer metastasis from solid mass that is surgically removable to
distant tissues and fluids of lungs, or distant organs.
The medical journal
Radiology published a story in early 2013 about medical malpractice mistakes by
radiologists, who are trained to read diagnostic tests, principally in
the form of imaging, to diagnose and recommend treatment and care for
patients. Baker, Stephen et al.,
The Demography of Medical Malpractice Suits Against Radiologists, Radiology, 266:539-547 (February 2013) (online 11-28-12). Whang, Jeremy et al.
The Cause of Medical Malpractice Suits Against Radiologists in the United
States, Radiology, 266:548-554 (February 2013) (online 11-30-12).
The recently-released Whang study found the most common general cause was
error in diagnosis (14.83 claims/1,000 person years). In this category,
breast cancer was most commonly missed (3.5 claims/1,000 person years)
- Non-spinal fractures – 2.9 claims/1,000;
- Spinal fractures – 1.32 claims/1,000;
- Lung cancer – 1.26 claims/1,000;
- Vascular disease – 1.08 claims/1,000.
Procedure complications accounted for 1.76 claims/1,000. Inadequate patient
communication was the cause of 0.4 claims/1,000 person years.
The Whang study concluded that “errors in diagnosis are, by far,
the most common generic cause of malpractice suits against radiologists.
In this category, breast cancer was the most frequently missed diagnosis
followed by non-vertebral fractures and spinal fractures.”
Undiagnosed breast cancer and mistakes with mammograms were the most common
problem. Radiologists reviewing mammography failed to (a) follow up on
previous or baseline studies, (b) compare suspicious lesions or cysts
from one test to the next to ascertain the presence or absence of changes,
and failure to order follow-up evaluative studies to confirm, or rule
out, a breast cancer diagnosis.
The HIPAA-compliant study was institutional review board approved. All
radiologists enrolled in the study were One-Call Medical providers. For
each radiologist a record of unfavorable outcomes and payment awards was
derived from narratives in the National Practitioners’ Data Bank.
All other matters were self-reported. Rates of malpractice claims per
state were calculated.
The results were as follows: in August 2010, 8,401 radiologists from forty-seven
(47) states composed One-Call Medical’s Panel. During their careers,
30.9% (2,600 of 8,401) were sued at least once for malpractice. There
was a wide variation in awards from Maine ($350,000) to Colorado ($24,105),
while mean payments varied nine-fold from Oregon ($715,707) to Nebraska
The study concluded that the likelihood of a radiologist being a defendant
in at least one suit is 50% by age sixty (60), yet the difference in frequency
and average number of suits accrued varies widely by state of residence
and gender. Among resolved suits, the percentage of cases in which payment
was made to the plaintiff differed markedly and varied intensively, apparently
based upon the degree of sophistication with which the patient and the
patient’s lawyer approached the case.