Navigating Malpractice: Guide for U.S. Radiologists

The majority of radiologists will face litigation in their careers, yet it remains an uncommon topic for training programs and educational conferences. The authors explore the landscape of radiology malpractice litigation to equip radiologists with essential knowledge before and in the event of a lawsuit. Radiologists should understand the four components necessary to be found liable for medical negligence: patient duty, breach of standard of care, injury, and proximate causality between the breach of standard of care and the injury. The authors introduce the mechanics of a lawsuit, common causes of lawsuits, and factors affecting risk. Many current radiologic norms and standards derive from legal precedent; examining these precedents and their effects on current practice through the context of prior litigated cases can help radiologists understand their evolving roles and responsibilities. Ultimately, 63% of malpractice claims are dismissed or dropped, 28% reach settlement agreements, and the remaining claims proceed to trial, where most result in defense wins. Radiologists should be familiar with common practices that may affect their legal risk, as well as potential misunderstandings regarding the discoverability of morbidity and mortality conferences, tumor boards, and other interdisciplinary conferences. Although litigation may not always be preventable, radiologists who understand the U.S. malpractice and medicolegal environment will be better positioned to mitigate unfavorable patient and legal outcomes. ^©RSNA, 2025.