Ensuring patient safety: a comprehensive approach to radiological errors

Radiologic errors arise from the interaction of human fallibility and systemic weakness. Using a fatigue-related missed renal mass, this paper proposes a model that joins two complementary duties: ethical transparency through disclosure and apology, and system redesign grounded in Just Culture and human factors engineering. Together, these principles create a sustainable path toward safety. We outline common malpractice sources, offer practical guidance for disclosure and apology, and emphasize institutional strategies that transform individual error into system learning and patient-centered improvement.