d. It is the radiologist's responsibility to require a proper radiological workup. If a
study is incomplete or substandard, the radiographer should advise the radiologist.
What determines the likelihood of showing liability of actionable negligence will be the
injury suffered and how obvious the missed pathological finding was.
SYGMAN vs KAHN (N.Y., 1985): MISSED DIAGNOSIS
A 49-year-old teacher was awarded 8,000 for a breast carcinoma that was not
diagnosed in a timely manner. The patient went to her internist, the attending
physician, for a breast lump. The internist referred her to a radiologist for a
mammogram without performing a physician examination or writing up a detailed
history. The mammogram was reported as negative. The patient later underwent a
mastectomy for a cancer that had, by then, spread to the ribs, skull and apertures.
The internist was liable for an act of omission, the failure to obtain a history. The
radiologist should have made sure that the history was documented by the Internist
prior to conducting the study.
SHUFFLER vs BLUE RIDGE RADIOLOGY ASSOCIATES, (N.C., 1985): MISSED
The patient was taken to an emergency room after falling from a truck. Spinal films
were ordered, but the x-ray technologist could not obtain films showing the last
cervical or first thoracic vertebra. In the radiologist's written report, no mention was
made of the problems in taking the films. The report simply indicated no identifiable
fractures of the patient's spine. In court, the radiologist testified that he had reported
the difficulties of the examination to the physician. The physician denied that he had
been so informed Twelve days after release, the plaintiff continued to suffer severe
pain in the back and neck, with a "big knot" apparent in the affected area. Films,
taken at the request of a neurosurgeon 22 days after the original films, revealed a
fracture dislocation for which the patient was placed in traction and underwent
surgery. The delay in detecting the fracture caused the patient 22 days of additional
significant pain and complications. The ruling In favor of the patient held that the
radiologist had established a standard of care when he stated the x-rays were
incomplete and that he had breached that standard. It was also found that the
radiologist's employer could be held liable since the radiologist had been acting as
part of the group.