AVERAGE LIABILITY PREMIUMS (1987)
Radiology
,000
Physicians
,000
Anesthesia
,000
Surgery
,000
OB/GYN
,000
EVER-INCREASING AVERAGE VALUE OF A CLAIM
1980
,000
1982
,000
1987
,000
Figure 4-3. This data, which is used in the 91P10 resident course, was obtained at a
Radiology Symposium held at St. Philip's College in San Antonio, Texas,
in September 1990. Although the figures are not as current as we would
have liked, they still suggest the trend toward ever-increasing claims and
premiums.
4-14. MISSED DIAGNOSES AND COMPLICATIONS
a. Radiologists are certainly not the only physicians who miss diagnoses. But a
missed diagnosis is the most likely reason for which a radiologist may end up in court.
In one study, the rate of disagreement among Harvard radiologists on the pathology of
chest radiographs (Herman et al, 1975) confirmed the results of other previous studies
in this regard.13 The Harvard radiologists disagreed up to 56 percent of the time and
had possible errors in 41 percent of their reports. Such disagreement can be found in
other studies, as well.
b. In the area of ultrasound-related suits, a 1984 survey by Dr. Sanders14 found
the missed ectopic pregnancy as the most frequent reason for litigation in the missed
diagnosis category. It also found several other nonobstetrical reasons for legal action,
including missed appendiceal abscesses and missed gallstones. Finding lesions when,
in fact, none existed, that is, carcinomas of the pancreas, gallstones, and IUDs, were
another common cause for litigation.
c. When a radiologist misses a pathological finding on an imaging study, the
critical question is whether the miss was through negligence or an error in judgment (a
distinction that is sometimes difficult to make). A physician is likely to be found
negligent if the injury resulted from a failure to follow accepted medical standards in
taking the patient's medical history and in conducting standard diagnostic tests or a
failure to use the most current medical knowledge and scientific methods in arriving at
the diagnosis.
MD0067
4-38
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