Original article
Communication Errors in Radiology: A Liability Cost Analysis

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Purpose

We evaluated the economic effect on radiologists involved in litigation of failures in communication of results.

Method

We examined claims data from the Physicians Insurers Association of America 2002 report on breast cancer and identified malpractice cases in which miscommunication, rather than misdiagnosis, was the primary cause for litigation.

Results

The average indemnity payment for primary errors in communication by radiologists was between $228,000 and $236,000, or twice as high as when appropriate communication occurred. As a percentage of total indemnity payments to plaintiffs, such awards were 15 times higher than when communication was effective.

Conclusions

Notwithstanding diagnostic accuracy, errors attributable to ineffective communication of results account for high indemnity awards. These errors can be easily resolved in clinical practice.

Section snippets

Methods and materials

The 2002 PIAA report database for delay in diagnosis of breast cancer was used, because the problem of direct communication was postulated to be a robust test of the effect of communication on patient outcome [3]. Most medical imaging is performed on symptomatic patients in whom the pretest probability of disease is likely to be higher, and the patient has usually been referred to an imaging facility with the expectation of a forthcoming result. The kinds of errors in communication that attend

Results

The mean age of the patients in this study was 50 years (range, 36–70 years); two-thirds (n = 20) were aged 50 years or younger. The overall average delay in the diagnosis of breast cancer was 11 months (range, 5–48 months). The average indemnity payment issued on behalf of radiologists was $269,000 (range, $26,600–$600,000) for cases in which payment was made on behalf of the radiologist and was $188,000 overall. The average indemnity payment for cases in which communication errors were

Discussion

In malpractice cases, expert witnesses are often called on to assist the court in determining standards of care for medical practice. Differences of opinion often exist, and the judge or jury is asked to weigh both the substance and credibility of such testimony in arriving at a decision. Indeed, in issues involving communication, experts may differ on the need for direct communication between the radiologist and referring physician when positive findings are revealed during imaging. As

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Copyright © 2005 American College of Radiology. American College of Radiology. Published by Elsevier Inc. All rights reserved.