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Oncologic Errors in Diagnostic Radiology: A 10-Year Analysis Based on Medical Malpractice Claims
Andrew B Rosenkrantz1, Dana Siegal2, Jillian A Skillings2
1Section Chief of Abdominal Imaging, Department of Radiology, NYU Langone Health, New York, New York.
Purpose:
To retrospectively analyze the nature and extent of oncology-related errors accounting for malpractice allegations in diagnostic radiology.
Methods:
The Comparative Benchmarking System of the Controlled Risk Insurance Company, a database containing roughly 30% of medical malpractice claims in the United States, was searched retrospectively for the period 2008 to 2017. Claims naming radiology as a primary service were identified and were stratified and compared by oncologic versus nononcologic status, allegation type (diagnostic versus nondiagnostic), and imaging modality.
Results:
Over the 10-year period, radiology was the primary responsible service for 3.9% of all malpractice claims (2,582 of 66,061) and 12.8% of claims with diagnostic allegations (1,756 of 13,695). Oncology (neoplasms) accounted for 44.0% of radiology cases with diagnostic allegations, a larger share than any other category of medical condition. Among radiology cases with diagnostic allegations, high-severity harm occurred in 79% of oncologic but just 42% of nononcologic cases. Of all oncologic radiology cases, 97.4% had diagnostic allegations, and just 55.0% of nononcologic radiology cases had diagnostic allegations. Imaging misinterpretation was a contributing factor for a large majority (80.7% [623 of 772]) of oncologic radiology cases with diagnostic allegations. The modalities most commonly used in oncologic radiology cases with diagnostic allegations involving misinterpretation were mammography and CT.
Conclusion:
Oncology represents the largest source of radiology malpractice cases with diagnostic allegations. Oncologic radiology malpractice cases are more likely than nononcologic radiology cases to be due to diagnostic errors. Furthermore, compared with those that are nononcologic, oncologic radiology cases with diagnostic allegations are more likely to be associated with high-severity harm. Efforts are warranted to reduce misinterpretations of oncologic imaging.
Insights
Oncology cases lead to the most radiology malpractice claims due to diagnostic errors. These cancer-related diagnostic errors in radiology are more likely to cause severe harm than non-cancer cases.
Area of Science:
- Radiology
- Medical Malpractice
- Oncology
Background:
- Medical malpractice claims in diagnostic radiology are a significant concern.
- Oncology cases represent a substantial portion of healthcare litigation.
- Understanding diagnostic errors in radiology is crucial for patient safety.
Purpose of the Study:
- To analyze the characteristics and frequency of oncology-related errors in diagnostic radiology malpractice claims.
- To compare oncology versus non-oncology malpractice allegations in radiology.
- To identify imaging modalities and error types associated with these claims.
Main Methods:
- Retrospective analysis of the Controlled Risk Insurance Company's malpractice claims database (2008-2017).
- Claims involving radiology as the primary service were identified and stratified.
- Comparison based on oncologic vs. non-oncologic status, allegation type, and imaging modality.
Main Results:
- Radiology was the primary service in 3.9% of all malpractice claims and 12.8% of diagnostic claims.
- Oncology accounted for 44.0% of diagnostic radiology malpractice claims.
- High-severity harm occurred in 79% of oncologic cases versus 42% of non-oncologic cases.
- Imaging misinterpretation was a factor in 80.7% of oncologic diagnostic claims, with mammography and CT being common modalities.
Conclusions:
- Oncology is the leading source of diagnostic radiology malpractice claims.
- Diagnostic errors are more prevalent in oncologic radiology malpractice cases.
- Oncologic radiology malpractice cases have a higher likelihood of severe patient harm, necessitating improved oncologic imaging interpretation.
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