Misreading Imaging Studies
Who is reading the imaging studies that are ordered for your condition?
In general the specialty of radiology trains physicians to evaluate and interpret those imaging studies. These radiologists almost never see you, the patient. Sometimes they review the chart, but not often. All they have to go on is a sentence or a few words explaining why the test is being ordered.
What is the radiologist supposed to do after reviewing the imaging studies? Generally they write or dictate a report that goes to the hospital chart or to the ordering physician. If the scan reveals a new emergency condition, the radiologist will call the ordering physician to inform him of the condition. These calls would normally be documented in the report.
In today’s new world of practice, some specialists own their own imaging machines and they dictate a report of the findings rather than having a radiologist interpret the images. This leads to an interesting situation where radiology mistakes might be made by non-radiologists who are actively treating the patient. Then you sometimes see just the opposite situation where the ordering physician never looks at the imaging test where a finding has been missed by the radiologist or by the partner of the physician.
I contend that all specialists need to examine all of the imaging tests that they order that are relevant to their specialty. I contend that to not look is not in keeping with acceptable and reasonable medical care. For example, a neurologist, neurosurgeon or spine surgeon must look at all brain and spine CT and MRI scans that they order.
Imaging Studies and Negligence
I have had a number of cases where obvious pathology was missed by both the radiologist and the ordering physician. As a result of these errors, I have seen a 30-year -old lose her vision, a 50-year-old woman have a brainstem hemorrhage that was avoidable and a 40-year-old woman have a hemorrhagic left hemisphere stroke that could have been prevented. In each of these cases, the abnormalities were inexplicably missed by qualified radiologists.
In another case I have, a woman had a post operative hematoma anterior to her cervical spine that was easily recognized on the imaging study but not recognized or reported on for many hours. The result was a catastrophic tracheal airway compression that caused severe brain injury from lack of oxygen. In each of these cases, a medical negligence claim was brought.