Baker Stephen R, Shah Shivam, Ghosh Shanchita, Castro Alejandro
Department of Radiology, New Jersey Medical School-Rutgers School of Biomedical and Health Sciences, Rutgers University, Newark, NJ, USA.
Emerg Radiol. 2015 Apr;22(2):141-5. doi: 10.1007/s10140-014-1268-3. Epub 2014 Sep 6.
The purpose of this study is to determine the prevalence, causes, and outcomes of GI malpractice suits in a survey of 8,401 radiologists. The malpractice histories of 8,401 radiologists from 47 states were evaluated from credentialing data of all radiologists participating in the network of One Call Medical Inc. Thirty-two percent of radiologists were defendants in at least one malpractice suit. Of the 4,073 total claims, 346 (8.49 %) were related to the gastrointestinal system. The most frequent primary allegations were failure to diagnose, 65.9 %, and procedural complications, 17.1 %. The commonest missed diagnoses were malignancy, 31.6 %; pneumoperitoneum, 19.3 %; and appendicitis, 14.5 %. Payment to the plaintiff occurred in 75.8 % of claims pertinent to cancer, 73.2 % for missed pneumoperitoneum, and 62.5 % related to appendicitis. Of cases in which a ruling was made in favor of the plaintiff, median payments for pneumoperitoneum was $215,000, for primary cancer $200,000, and for appendicitis $60,000. Among procedurally related errors resulting in judgment against a defending radiologist, 78.6 % of claims regarding retained foreign body, 75 % of barium enema cases, and 62.5 % of liver biopsy resulted in a payment to the plaintiff. Among all resolved cases, the median award was $30,000 for unrecognized foreign body retention, $100,000 for barium enema complications, and $400,000 for liver biopsy complication. Of all GI malpractice claims, failure to diagnose was the most prevalent. Among them, approximately three fourths of claims related to either the diagnosis of primary cancer or for detection of a pneumoperitoneum.
本研究的目的是通过对8401名放射科医生的调查,确定胃肠道医疗事故诉讼的发生率、原因及后果。从参与One Call Medical Inc.网络的所有放射科医生的资质数据中,评估了来自47个州的8401名放射科医生的医疗事故历史。32%的放射科医生至少参与过一起医疗事故诉讼的辩护。在总共4073起索赔中,346起(8.49%)与胃肠道系统有关。最常见的主要指控是漏诊,占65.9%,以及操作并发症,占17.1%。最常见的漏诊疾病是恶性肿瘤,占31.6%;气腹,占19.3%;阑尾炎,占14.5%。与癌症相关的索赔中,75.8%向原告支付了赔偿金;气腹漏诊的索赔中,73.2%支付了赔偿金;阑尾炎相关的索赔中,62.5%支付了赔偿金。在做出有利于原告裁决的案件中,气腹漏诊案件的中位赔偿金额为21.5万美元,原发性癌症案件为20万美元,阑尾炎案件为6万美元。在导致放射科医生败诉的与操作相关的错误中,78.6%的关于异物残留的索赔、75%的钡剂灌肠病例以及62.5%的肝活检病例向原告支付了赔偿金。在所有已解决的案件中:异物残留未被识别的中位赔偿金额为3万美元,钡剂灌肠并发症为10万美元,肝活检并发症为40万美元。在所有胃肠道医疗事故索赔中,漏诊最为普遍。其中,约四分之三的索赔与原发性癌症诊断或气腹检测有关。