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TMLT
RISK MANAGEMENT
one expert stated that although diagnosis of the fracture was missed, vical fracture was misread. Documentation of attempts to commu-
usually 4% of radiological studies are misread, and this is why there nicate the findings to another physician or the patient may have as-
is an over-reading process. The findings provided by Radiologist B sisted in the defense of this case.
were reported in sufficient time for the ED staff to contact the patient
and have her return to the hospital. While after-hours teleradiology is standard practice in health care
today, a missed diagnosis may have far reaching implications, espe-
One physician reviewer noted that it was more than 100 hours cially for decisions about patient care in the ED. Radiologists who
after the initial fall that the patient developed quadriplegia. He be- provide interpretive services from a location other than the hospital
lieved an additional injury or event may have been a causative factor. where the patient is being treated have unique responsibilities to prac-
tice prudently and cautiously, as the effect of injuries may be pro-
Disposition gressive in nature.
Given the difficulty in finding supportive experts, the case against
The information and opinions in this article should not be used
Radiologist A was settled. The hospital and neurosurgeon also settled or referred to as primary legal sources nor construed as establishing
their cases. The lawsuit against the second radiologist was dropped, medical standards of care for the purposes of litigation, including ex-
and the outcome of the cases against the ED physicians is unknown. pert testimony. The standard of care is dependent upon the particular
facts and circumstances of each individual case and no generalization
Risk management considerations can be made that would apply to all cases. The information presented
When several physicians are involved in a single patient’s care, there should be used as a resource, selected and adapted with the advice of
your attorney. It is distributed with the understanding that neither
is greater risk for missed communication among the professionals or Texas Medical Liability Trust nor Texas Medical Insurance Company
with the patient. In this case there seemed to be a chain reaction of is engaged in rendering legal services. © Copyright 2012 TMLT.
missed opportunities initiated when the initial diagnosis of the cer-
