Malpractice litigation in diagnostic radiology with special focus on cases in the abdomen and pelvis: A comprehensive analysis from a national legal database.

Abstract

Objective: Diagnostic radiology is regarded as a "high-risk" specialty in the medical malpractice literature. This study examines the causes and patterns and types of medical malpractice litigation and outcomes in radiology in the United States, with a particular focus on diagnostic radiology errors involving the abdomen and pelvis.

Methods: Malpractice suits in which the defendant was a radiologist in the United States from 2008 to 2018 were identified using LexisAdvance, a national legal database. 2775 cases were initially identified, and 1165 cases fit the inclusion criteria.

Results: Diagnostic error was the most prevalent error type, (n = 925, 82.9 %), followed by procedural errors (n = 106, 9.5 %), communication errors (66 cases, 5.9 %), and mixed/other errors (n = 19, 1.7 %). Breast was the most common imaging modality implicated in medical error (n = 211, 26.4 % of total cases), followed by CT (n = 186, 23.3 %), and XR (n = 146, 18.3 %). Out-of-court settlement was the most common outcome (n = 402, 44.5 %), followed by a verdict ruled in favor of the defendant (n = 246, 27.2 %) and case dismissal (n = 131, 14.5 %). The average award in a settlement was $1,500,690 USD (range: $25,000- $10,200,000 USD). The average award in a jury verdict for the plaintiff was $2,857,203 USD (range: $60,000- $31,490,000 USD), and the average award in arbitration for the plaintiff was $1,354,497 USD (range: $200,000- $2,800,000 USD). The gastrointestinal (GI) system and the genitourinary (GU) system accounted for 51.9 % and 25.9 % of errors in the abdomen and pelvis, respectively.

Discussion: Diagnostic error was the most prevalent source of error leading to malpractice litigation. Breast imaging was the most frequently implicated imaging modality in litigations, followed closely by CT and XR. A majority of cases were resolved through out-of-court settlement or with judgments in favor of the defendant radiologists. However, in cases with trial judgments in favor of the plaintiff, average financial awards were higher than out-of-court settlements. Abdomen and pelvic involvement accounted for frequent sources of error.