The Diagnostic Uncertainties and Legal Precedents in Appendicitis Malpractice

Acute appendicitis is the commonest surgical emergency, yet its presentation can be atypical, often resembling non-urgent conditions. Delayed or missed diagnosis of appendicitis carries not only clinical risk but also significant legal exposure. Retrospective analyses of malpractice claims have long identified appendicitis as one of the top causes of emergency department malpractice suits. This article explores the medicolegal landscape surrounding appendicitis, highlighting common diagnostic errors, the transformative impact of widespread computed tomography (CT) use, and recent verdicts. It also examines the key legal principles involved in such cases, with a focus on how diagnostic uncertainty and communication breakdowns in the emergency department (ED) affect radiologists. Finally, we emphasize the radiologist's duty to clearly report imaging findings and to ensure critical results are communicated to the treating clinician, using a closed-loop communication system. Ultimately, both radiologists and emergency providers must stay alert to the varied manifestations of appendicitis and follow established imaging and follow-up protocols to enhance patient care and mitigate medicolegal exposure.