From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, Box 208042, Tompkins East 2, New Haven, CT 06520-8042 (A.K., S.B., M.K., S.P., J.M., A.M.); Department of Neuroradiology, MD Anderson Cancer Center, Houston, Tex (M.W.); and Departments of Interventional Neuroradiology, Radiology, Nuclear Medicine, Neurology, and Neurosurgery, University of Maryland School of Medicine, Baltimore, Md (D.G.).
Radiology. 2023 Sep;308(3):e230802. doi: 10.1148/radiol.230802.
Background Radiology ranks high in terms of specialties implicated in medical malpractice claims. While most radiologists understand the risks of liability for missed findings or lapses of communication, liability for the use of contrast agents in imaging procedures may be underappreciated. Purpose To review the clinical context and outcomes of lawsuits alleging medical malpractice for contrast-related imaging procedures. Materials and Methods Two large U.S. legal databases were queried using the terms "Contrast" and "Radiology OR Radiologist" from database inception to October 31, 2022, to identify cases with published decisions or settlements related to medical malpractice in patients who underwent contrast-related imaging procedures. The search results were screened to include only those cases involving the practice area of health care law where there was at least one claim of medical negligence against a health care institution or provider. Data on the medical complications alleged by patients after contrast agent administration and on the trial were extracted and reported using descriptive statistics. Results A total of 151 published case summaries were included in the analysis. Anaphylactic reaction following contrast agent administration was the most common medical complication observed (30% [45 of 151 cases]), of which failure to diagnose developing anaphylaxis or failure to treat the anaphylactic reaction made up the majority of allegations (93% [42 of 45]). Inappropriate management of contrast media extravasation (27% [41 of 151]) and alleged contrast agent-induced acute kidney injury (13% [19 of 151]) were the next most frequent causes of lawsuits. Of the 11 cases of alleged kidney injury that went to trial, all resulted in a judgment in favor of the defense. Conclusion This study highlights the key reasons for medical malpractice lawsuits associated with use of contrast media and outcomes from these lawsuits. © RSNA, 2023 See also the editorial by Trop in this issue.
背景 放射科在涉及医疗事故索赔的专业中排名很高。虽然大多数放射科医生都了解因漏诊或沟通失误而承担法律责任的风险，但对影像检查中使用造影剂的责任可能认识不足。 目的 回顾指控造影相关影像检查医疗事故的诉讼的临床背景和结果。 材料与方法 从数据库创建到 2022 年 10 月 31 日，使用“造影剂”和“放射学或放射科医生”这两个美国大型法律数据库中的术语进行查询，以确定与接受造影相关影像检查的患者的医疗事故相关且有已公布裁决或和解结果的案例。筛选搜索结果，仅包括涉及医疗保健法实践领域的案例，至少有一起针对医疗机构或提供者的医疗过失索赔。提取并使用描述性统计方法报告患者在接受造影剂后出现的医疗并发症和审判相关数据。 结果 共有 151 份已发表的案例摘要被纳入分析。造影剂给药后发生过敏反应是观察到的最常见的医疗并发症（30%[151 例中的 45 例]），其中未能诊断出发生过敏反应或未能治疗过敏反应构成了大多数指控（93%[45 例中的 42 例]）。造影剂外渗的不当处理（27%[151 例中的 41 例]）和指控造影剂引起的急性肾损伤（13%[151 例中的 19 例]）是引起诉讼的下一个最常见原因。在 11 例涉嫌肾损伤的审判案件中，所有案件的判决均有利于辩方。 结论 本研究强调了与使用造影剂相关的医疗事故诉讼的主要原因以及这些诉讼的结果。©RSNA，2023 本期还刊登了 Trop 的社论。
