Diagnostic delays the most common cause of patient injury in radiology

Delayed diagnosis is the most common cause of patient injury in radiology while mammography is the most involved modality, according to a new decades-long data dive, published Monday.

Medical malpractice, infection or complication all represented the second most common cause of such claims, while incorrect/inadequate diagnosis came in third. The findings are part of an analysis of radiology-related malpractice claims from 1991-2017 in Finland, published in the journal Insights into Imaging.

“Patient injury in imaging examinations and interventions cannot be completely prevented. However, injury data are an important source of information for healthcare,” concluded Tarja Tarkiainen, with the Department of Diagnostic Radiology at Oulu University Hospital in Finland, and colleagues. “By analyzing claims, we can prevent harm, increase the quality of care, and improve patient safety in medical imaging.”

For their analysis, Tarkiainen et al. looked to data from the Finnish Patient Insurance Center, which handles all notices of patient injury in the Nordic country. The review turned up 1,054 claims—or an average of 87 per year between 2005-2014—for inclusion in the study.

Delayed diagnosis was the leading cause of injury, representing 38% of claims, followed by medical malpractice, infection or complication at 34%. Incorrect or inadequate diagnosis rounded out the top 3 at nearly 17%. Most claims involving infections or other complications occurred in diagnostic and therapeutic vascular and interventional radiology (64%), the authors reported.

Mammography was the modality with the most patient injuries (nearly 30%), followed by radiography (16%) and MRI (15%). The analysis unearthed 22 (or 2.1%) fatal or life expectancy-shortening cases in the specialty. Nine were related to interventional radiology, six in MRI, five in CT, and one apiece in X-ray and ultrasound. Those included a delay in the treatment of a recurrent aneurysm, bleeding after a thin-needle biopsy caused an airway obstruction, and a brain tumor missed initially on MRI.

The study is limited by its single-country sample, and the authors said it’s likely only a portion of patient claims were reported to authorities. However, Tarkiainen and colleagues believe the data can offer quality improvement clues to providers in other countries. Of note, Finland operates a no-fault system, encouraging professionals to identify system failures and take actions to fix them. That’s in contrast to the U.S. and U.K., which use a tort-liability system in which patients are compensated if they can prove harm was the result of negligence, the authors noted.

You can read more about their findings in Insights into Imaging here.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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