Radiology malpractice claims in China: A retrospective analysis of 79 cases from 2011 to 2024

To investigate the characteristics and common errors of radiology malpractice claims in China.

Seventy-nine radiology malpractice claims in China from 2011 to 2024 were retrospectively collected. Demographics, clinical setting, radiological procedure, anatomical site, radiological diagnosis, medical error, judicial outcome, and compensation data were extracted and analyzed descriptively.

The mean age of patients was 43.54 ± 20.13 years. Claims mainly involved outpatients (68.4%). Conventional radiography (32.9%), ultrasonography (31.7%), and CT (27.9%) were the most frequent radiological procedures. Most claims were in the musculoskeletal system (32.9%), followed by obstetrics (19.0%), chest (16.5%, 15.2% Lung), head (10.1%), breast (10.1%), abdominal and genitourinary (8.9%), and pelvic and perineum (2.5%). Tumors (36.5%) were the most common disease involving diagnostic errors, mainly lung cancer (17.5%) and breast cancer (12.7%). Fractures followed (25.4%), primarily complete fractures (12.7%). The third were congenital anomalies (17.5%), primarily including limb deformity (9.5%) and congenital heart disease (6.4%). Diagnostic errors (79.8%) constituted primary medical errors, predominantly missed diagnosis (68.4%). Communication errors accounted for 27.9%, mainly failure to adequately fulfill the duty to inform (25.3%). Technical errors were uncommon (5.1%). Among 69 adjudicated cases, 66 received compensation (range: $0.14-$171,870.92, mean: $25,761.06 ± $32,049.66).

Diagnostic errors, especially missed diagnoses of complete fractures in long limb bones, lung cancer, breast cancer, and congenital anomalies, were the leading cause of the claims. Establishing standardization of radiological procedures, enhancing quality control, cultivating good communication skills among radiologists and establishing standardized communication protocols are critical areas for reducing risk.