Litigation Risk Between Different Subspecialties?

[19pieces19]

Has there ever been any data looking at the different risks of getting sued depending on which subspecialty you are going into? My impression based on no data at all is that breast would be higher because of how many mammograms they go through and how important breast cancer is in the public eye, but I have no idea if this is true or not. I feel like MSK would be lower?

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[MadRadLad]

Mammo is the highest I believe. Breast cancer can be aggressive, mammography is not that great to start with, and of course the public eye contributes. The rest are a chunk below. Maybe neuro or body are next due to stroke and aortic/vascular pathology. Agree it's probably rare to miss a clinically significant finding in MSK.

 

[SeisK]

Peds and mammo are high risk endeavors.

I’d guess that Nucs and MSK are probably least, I’d imagine Nucs is lowest. PET scans are staging scans for an already diagnosed condition, and attenuation-correction resolution is too low to make out subtle critical findings.

 

[colbgw02]

Not that this is a subspecialty, but OB ultrasound is up there in terms of risk.

Heard not too long ago that plaintiffs' attorneys are cooling on suing over mammo. It's enough of a Rorschach test that getting a consensus among expert witnesses is virtually impossible. No clue if that's accurate, and I really hope I never have to find out for myself.

 

[GadRads]

Not that this is a subspecialty, but OB ultrasound is up there in terms of risk.

Heard not too long ago that plaintiffs' attorneys are cooling on suing over mammo. It's enough of a Rorschach test that getting a consensus among expert witnesses is virtually impossible. No clue if that's accurate, and I really hope I never have to find out for myself.

I wonder what misses on OB ultrasound lead to malpractice lawsuits.

 

[SeisK]

I wonder what misses on OB ultrasound lead to malpractice lawsuits.

You missed the subtle echogenic cardiac focus which would have led to prenatal testing for Downs, which the mother would have aborted.

The tech forgot to give dedicated images of the internal cervical os which would have demonstrated vasa previa and you were too swamped / behind the list to notice, so when the patient went into labor instead of Caesarian she exsanguinated and died. They were subtly there on a rapid-sweep cine through the LUS.

You missed the subtle twin-twin transfusion findings which led to the preventable demise of both fetuses. Etc.

 

[Cognovi]

Mammo is the highest I believe. Breast cancer can be aggressive, mammography is not that great to start with, and of course the public eye contributes. The rest are a chunk below. Maybe neuro or body are next due to stroke and aortic/vascular pathology. Agree it's probably rare to miss a clinically significant finding in MSK.

Is that because there are fewer clinically significant findings in MSK

 

[CallMeBigJeff]

Hard disagree on MSK.

I read a paper on lawsuits by specialty and of course mammo was #1, MSK was close second. Think of your chances of missing a subtle fracture when you're blasting through 100+ PFs in a day and some hick suing you for pain and suffering because the ED doc turned them because of the negative radiograph and they come back 2 weeks later with nicely resorbed fracture lucency and/or periosteal reaction

 

[MadRadLad]

Hard disagree on MSK.

I read a paper on lawsuits by specialty and of course mammo was #1, MSK was close second. Think of your chances of missing a subtle fracture when you're blasting through 100+ PFs in a day and some hick suing you for pain and suffering because the ED doc turned them because of the negative radiograph and they come back 2 weeks later with nicely resorbed fracture lucency and/or periosteal reaction

Do these end up paying out anything significant though?

 

[19pieces19]

Hard disagree on MSK.

I read a paper on lawsuits by specialty and of course mammo was #1, MSK was close second. Think of your chances of missing a subtle fracture when you're blasting through 100+ PFs in a day and some hick suing you for pain and suffering because the ED doc turned them because of the negative radiograph and they come back 2 weeks later with nicely resorbed fracture lucency and/or periosteal reaction

Curious to read the literature, do you have the source?

 

[Cognovi]

Redirecting

 

[meister]

You missed the subtle echogenic cardiac focus which would have led to prenatal testing for Downs, which the mother would have aborted.

The tech forgot to give dedicated images of the internal cervical os which would have demonstrated vasa previa and you were too swamped / behind the list to notice, so when the patient went into labor instead of Caesarian she exsanguinated and died. They were subtly there on a rapid-sweep cine through the LUS.

You missed the subtle twin-twin transfusion findings which led to the preventable demise of both fetuses. Etc.

Nightmare fuel

 

[Melkor]

OB US for sure is the highest if you want to get into specific exams. You're at the mercy of the tech to show you everything and then you have to actually know what everything means/see subtle US findings. 1 miss and now you've got a pt that will likely live 15-70 years with a serious and super expensive condition that the mother may have otherwise aborted if known about. And it's not like the miss is going to go unnoticed to the pt compared to missing a small breast cancer on a screening mammo that is picked up the next year. They are going to be born and then it's going to be super obvious. It's not even a case. It's just a sign your negligence papers. Gotta pay the big bucks to support them for the rest of your life even if it was the techs fault for not showing you the right images.

Mammo is always the one that people talk about and probably is most common I guess but I see way more stupid malpractice cases that aren't the rads fault successfully go to the trial than sheer negligence cases. Of course I don't have large data sets to go off of so it's just my personal experience.

 

[HounsfieldUnit]

The level of OB liability is going to be very state by state and not generalizable to all rads.

Got to spend time today learning about the term Wrongful Birth. Kinda ****ed up as the kid if you ever learn your mom sued the doctor and got a bunch of blood money because she would have killed you if she could. I guess another good reason to work in a red state where abortion is illegal and Wrongful Birth was banned as a cause of malpractice action. You can't sue me because you don't like your funny lookin' baby.