Radiology and the Law

by Eisenberg, Ronald L.; Smith, John J.; Thorwarth, William T.

• ISBN13: 9780387403090
• ISBN10: 0387403094
• Format: Paperback
• Copyright: 2003-11-01
• Publisher: Springer Verlag

Summary

Practically every radiologist would benefit from an all-encompassing guide to malpractice issues in radiology. Dr. Ronald Eisenberg, a highly respected author in the field, has put together a comprehensive reference to provide radiologists with an introduction to malpractice issues and a basic understanding of their relationships with government regulatory agencies and HMOs. This softcover book will detail the mechanics of a lawsuit, how radiologists can become the object of a malpractice action, and what they can do to minimize potential exposure.

Table of Contents

Foreword	vii
John J. Smith
Foreword	ix
William T. Thorwarth, Jr.
Preface	xi
Part I Malpractice Litigation
Malpractice	3	(19)
Duty	4	(9)
Breach of Duty	13	(1)
Injury (Damages)	13	(1)
Causation	14	(1)
Res Ipsa Loquitur	14	(1)
Defenses and Limitations to a Malpractice Suit	15	(7)
Vicarious Liability	22	(9)
Employees Versus Independent Contractors	23	(1)
Liability for Acts of Technologists	23	(2)
Liability for Acts of Residents	25	(1)
Liability of Chairpersons Administering Departments	26	(1)
Liability for Acts of Partners	27	(1)
Hospital Liability for Acts of Physicians	27	(4)
Standards and Practice Guidelines	31	(6)
American College of Radiology Standards	33	(1)
Departmental Standards	33	(1)
Legal Effect of Standards and Practice Guidelines	34	(1)
State Legislation	35	(2)
Anatomy of a Malpractice Lawsuit	37	(9)
Prefiling Procedures	37	(1)
Formal Filing	38	(1)
Discovery	39	(1)
Deposition	40	(1)
Settlement Attempts	41	(1)
Pretrial Conference	41	(1)
Summary Judgment	42	(1)
Trial	42	(2)
Appeal	44	(2)
Expert Witnesses	46	(10)
Availability	46	(1)
Role	47	(1)
Limitations	48	(1)
Qualifications	48	(2)
Consequences of Disqualification to the Witness	50	(1)
Proper Behavior of an Expert Witness	50	(1)
``Reasonable Degree of Medical Certainty'' Standard	51	(1)
Practical Tips for the Radiology Expert Witness	52	(1)
Ethical Considerations	52	(1)
Adverse Consequences of Being an Expert Witness	52	(1)
Protecting the Radiologist from Being Falsely Accused by an Expert Witness	53	(3)
Countersuits	56	(3)
Possible Causes of Action	56	(1)
What Should a Radiologist Do If Subjected to an Unjustified Suit?	57	(2)
Alternative Dispute Resolution	59	(3)
Limitations of Formal Adjudication	59	(1)
Mediation	59	(1)
Arbitration	60	(1)
Alternative Dispute Resolution in Medical Malpractice	60	(2)
Criminal Prosecution	62	(2)
Professional Liability Insurance	64	(7)
Insurance Contracts	64	(1)
Occurrence Versus Claims-Made Policies	64	(1)
Tail and Nose Policies	65	(1)
Mandatory Insurance Requirements	66	(1)
Amount of Insurance Coverage	66	(1)
The Deep Pocket	67	(1)
Defense of Malpractice Claims	67	(1)
Settlement of Lawsuits	68	(3)
Special Residency Issues	71	(3)
Insurance	71	(1)
Special Liability Status	72	(2)
Reactions of Physicians Sued for Malpractice	74	(4)
Supporting a Sued Radiologist	75	(3)
Role of the Radiologist-Defendant at Trial	78	(2)
Risk Management	80	(5)
Communication with Patients	80	(5)
Part II The Missed Diagnosis: Overview
The Missed Diagnosis: Overview	85	(16)
Frequency of Errors	85	(1)
Causes of Errors	86	(5)
Admitting Errors	91	(2)
Reporting the ``Missed'' Diagnosis	93	(2)
Defending the ``Missed'' Radiographic Diagnosis	95	(6)
Interpreting Too Many Studies Per Day	101	(6)
Part III Communication and Records
Radiology Reports	107	(8)
Comparison with Previous Examinations and Reports	109	(1)
Significant Discrepancy Between the Final and Emergency/Preliminary Reports	110	(1)
Signing the Radiology Report	111	(1)
Correction/Alteration of the Radiology Report	112	(3)
Communication of the Radiologic Findings	115	(8)
Failure to Issue a Report	115	(1)
Delay in Issuing a Report	116	(1)
Direct Communication	117	(6)
Release and Storage of Radiologic Images	123	(5)
Ownership of Images	123	(1)
Patient Access to Images	123	(2)
Confidentiality	125	(1)
Retention of Images	125	(1)
Storage and Destruction of Images	126	(2)
Medical Records	128	(4)
Importance of Proper Medical Records	128	(1)
Correction/Alteration of the Medical Record	129	(1)
Adverse Consequences of Improper Alteration of Medical Record	129	(1)
Inappropriate Entries	130	(2)
Confidentiality	132	(7)
HIV-Positive Patients	134	(5)
Part IV Radiology Practice and Specific Procedures
Consent	139	(10)
Types of Consent	139	(1)
Informed Consent	140	(9)
Do Not Resuscitate (DNR) Orders	149	(5)
Compliance with DNR Orders	150	(1)
Recommended Approach	151	(1)
Consequences of Failure to Comply with a DNR Order	152	(2)
Barium Enema	154	(2)
Breast Imaging	156	(16)
Risk of Women Developing Breast Cancer	156	(1)
Mortality Rates	157	(1)
Accuracy of Mammography	157	(1)
Effect of Mammography on Lengthening Survival Time and Reducing Death Rates	158	(1)
Effect of Delayed Diagnosis of Breast Cancer	159	(1)
Screening Versus Diagnostic Mammograms	160	(2)
Mammographic Errors	162	(1)
Reporting the Mammographic Study	162	(2)
False-Negative Core Biopsy of the Breast	164	(1)
Specimen Radiography	165	(1)
Tracking Patients with Negative Biopsies	166	(6)
Interventional Procedures	172	(4)
Technical Issues	172	(1)
Postprocedure Care	173	(3)
Ionic Versus Nonionic Contrast Material	176	(3)
Sedation and Analgesia	179	(4)
Pediatric Patients	179	(2)
Adult Magnetic Resonance Imaging	181	(1)
Interventional Procedures	182	(1)
Medical Devices	183	(6)
Off-Label Use	184	(2)
Informed Consent for Off-Label Use	186	(1)
Reprocessing and Reuse of Single-Use Devices	186	(3)
The Pregnant Patient	189	(4)
Effect of Radiation Exposure on the Fetus	189	(1)
Determining Whether a Woman Is Pregnant	190	(1)
Examining the Pregnant Patient	190	(1)
Radionuclide Imaging	191	(2)
Computed Tomography Screening Studies	193	(12)
General Criteria for Effective Screening	193	(1)
Radiation Risk	194	(1)
CT Screening for Lung Cancer	195	(1)
CT Screening for Coronary Artery Disease	196	(1)
CT Screening for Abdominal Pathology	197	(1)
Use of Contrast Material in Screening CT Studies	198	(1)
Medical-Legal Implications	198	(7)
Part V Electronic Imaging
Teleradiology	205	(5)
Establishment of Physician-Patient Relationship	205	(1)
Medical Licensing and Insurance	206	(1)
Jurisdiction for Malpractice Suits	207	(1)
Other Medical-Legal Aspects	207	(1)
Relationship Between Local and Distant Radiologists	208	(2)
E-Mail	210	(5)
Other Potential Problems with E-Mail	212	(3)
Picture Archiving and Communications Systems (PACS)	215	(6)
Failure to Interpret ``Lost'' PACS Images	216	(5)
Part VI Governmental/Regulatory
Credentialing and Peer Review	221	(5)
Due Process	221	(2)
Peer Review	223	(3)
Infected or Substance-Abuse-Impaired Radiologist	226	(4)
Liability of the Infected/Impaired Radiologist	226	(1)
Liability of Other Parties	227	(1)
Informed Consent	228	(2)
Federal Fraud and Abuse Enforcement and Compliance Plans	230	(7)
Fraud and Abuse	230	(2)
Compliance Plans	232	(3)
Documentation	235	(2)
Professional Courtesy	237	(3)
Sexual Harassment	240	(4)
Sexual Harassment Policy	240	(1)
Allegations of Sexual Harassment	241	(1)
What to Do If One Is a Victim of Sexual Harassment	241	(1)
Employer Course of Action	242	(2)
Employee Retirement Income Security Act (ERISA)	244	(5)
Impact on Radiologists	247	(2)
Index	249