A new national analysis found that diagnostic errors drove the vast majority of malpractice claims within radiology.
The analysis, recently published in Current Problems in Diagnostic Radiology, examined U.S. malpractice suits naming a radiologist as a defendant between 2008 and 2018. Researchers identified cases using LexisAdvance, a national legal database, screening 2,775 potential suits down to 1,165 that met the study’s inclusion criteria.
Here are nine takeaways from the study:
1. Diagnostic error is the dominant cause. A missed, delayed or incorrect read of an image was the cause in 82.9% of cases — far more than procedural errors (9.5%), communication errors (5.9%) or mixed and other causes (1.7%).
2. Breast imaging draws the most litigation. It was the imaging modality implicated in 26.4% of all cases, more than CT (23.3%) or X-ray (18.3%). Researchers tied breast imaging’s outsized share to its role as a screening tool, where a missed finding can mean a delayed cancer diagnosis.
3. CT and X-ray round out the top three. Together with breast imaging, those three modalities account for the bulk of all radiology malpractice claims in the dataset.
4. GI findings dominate abdominal and pelvic cases. Within the subset of suits centered on the abdomen and pelvis, gastrointestinal findings accounted for 51.9% of errors.
5. GU findings are the second-largest source. Genitourinary findings made up another 25.9% of abdominal and pelvic errors, meaning more than three-quarters of these claims trace back to just two organ systems.
6. Most cases settle out of court. An out-of-court settlement was the most common outcome, closing 44.5% of cases, followed by a verdict for the defendant radiologist (27.2%) and case dismissal (14.5%).
7. Settlements average $1.5 million. The average settlement paid to a plaintiff was $1,500,690, ranging from $25,000 to $10,200,000.
8. Jury verdicts cost nearly double a settlement. Cases decided for the plaintiff at trial averaged $2,857,203, with awards as high as $31,490,000. Arbitration awards for plaintiffs, by contrast, averaged $1,354,497, ranging from $200,000 to $2,800,000.
9. AI workflow design may change the calculus. A mock-trial study published this year found that jurors’ perception of liability shifted based on how AI was folded into a radiologist’s review process. In a simulated case involving a missed brain bleed, nearly 75% of mock jurors found the radiologist breached the standard of care with a single AI-informed review, versus about 53% when radiologists conducted a double read — before and after the AI flag.
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