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Radiology offers a presumptive but neither a histological nor microbiological diagnosis. Missed fractures in emergency and communication issues between radiologists and physicians are also discussed. This article focuses on the spectrum of diagnostic errors in radiology, including a classification of the errors, and stresses the malpractice issues in mammography, chest radiology and obstetric sonography. Identification and reduction of diagnostic error provides a measure of the efficacy of the healthcare system, as it reduces mortality, morbidity, length of hospital stay and additional healthcare costs. There is thus the need to analyze the extent and causes of the phenomenon, which would also help to identify the most effective measures in terms of clinical risk management.

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Physicians may feel a sense of guilt resulting from the error and may fear suffering professional and economic consequences and being isolated by their own colleagues and clients. Perceived stress is associated with an increase in the number of errors committed in the subsequent period, thus creating a vicious cycle whereby errors lead to stress, which in turn leads to new errors. Medical professionals who have committed a severe error are open to a reduction in quality of life and an increase in the frequency of burnout. Litigation for alleged malpractice is often associated with feelings of guilt and isolation.

In addition to economic and social effects, malpractice lawsuits have often direct effects on a physicianвЂ™s health. Types of procedures that prompt or contribute to litigation include biliary drainage, stone extraction, cholecystostomy, nephrostomy, abscess drainage, tract dilation, biopsy and contrast material administration. Informed consent for procedures related to interventional radiology is a relatively frequent source of legal problems as well. Lack of appreciation of colorectal carcinoma on barium enema studies, lung nodules on chest radiographs, breast lesions on mammograms, and bone tumors on plain radiographs are the predominant problems. The second type of вЂњmissвЂќ is failure to diagnose cancer. The most commonly missed fractures include those in the femur, the navicular bone, and the cervical spine. Radiologic вЂњmissesвЂќ typically are one of two types: either missed fractures or missed diagnosis of cancer. The three main categories of claims include misdiagnoses, complications, and miscellaneous.

These types of claims account for about 40%-54% of radiology-related medical malpractice cases. This means oversight of abnormalities or misinterpretation of radiologic images. Radiologic problems that have led to medical malpractice lawsuits most frequently have been due to вЂњfailure to diagnoseвЂќ. Reducing errors will improve patient care, may reduce costs and will improve the image of the hospital. The main reason for studying medical errors is to try to prevent them. Robinson pointed out that radiologyвЂ™s Achilles heel is вЂњerror and variation in the interpretation of the Roentgen imageвЂќ. An error in the interpretation of a radiograph, including misdiagnosis or failure to diagnose, is an example of a general type of claim in radiology.

Missed fractures in emergency and communication issues between radiologists and physicians are also discussed.ДЄ malpractice claim arises when a patient believes that improper medical care has resulted in bodily harm. Error traps need to be uncovered and highlighted, in order to prevent repetition of the same mistakes. Every radiologist should understand the sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation. The work of diagnostic radiology consists of the complete detection of all abnormalities in an imaging examination and their accurate diagnosis. Errors arise from poor technique, failures of perception, lack of knowledge and misjudgments. The etiology of radiological error is multi-factorial. Most often, a plaintiffвЂ™s complaint against a radiologist will focus on a failure to diagnose. Radiology is one of the specialties most liable to claims of medical negligence. Since the early 1970s, physicians have been subjected to an increasing number of medical malpractice claims. Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care.

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