Radiology and the law : malpractice and other issues / Ronald L. Eisenberg ; foreword by John J. Smith ; foreword by William T. Thorwarth, Jr.

Format:

Book

Author/Creator:

Eisenberg, Ronald L.

Language:

English

Subjects (All):

Radiologists--Malpractice--United States.

Radiologists.

Radiology--legislation & jurisprudence.

Radiologists--Malpractice.

United States.

Malpractice.

Medical Subjects:

Radiology--legislation & jurisprudence.

United States.

Malpractice.

Physical Description:

xviii, 265 pages ; 24 cm

Place of Publication:

New York : Springer, [2004]

Summary:

Diagnostic radiology is near the top of the list of procedures involved in malpractice claims. In fact, a substantial number of practicing radiologists face lawsuits during their careers. Ronald L. Eisenberg, a radiologist, a lawyer, and a highly respected author in the field, has written this comprehensive guide in order to introduce radiologists to malpractice issues. Readers will gain a basic understanding of their relationships with governmental regulatory agencies and HMOs. This book also details the mechanics of a lawsuit, how radiologists can become the objects of malpractice actions, and what radiologists can do to minimize potential exposure.

Contents:

Part I Malpractice Litigation

Chapter 1 Malpractice 3

Duty 4

Breach of Duty 13

Injury (Damages) 13

Causation 14

Res Ipsa Loquitur 14

Defenses and Limitations to a Malpractice Suit 15

Chapter 2 Vicarious Liability 22

Employees Versus Independent Contractors 23

Liability for Acts of Technologists 23

Liability for Acts of Residents 25

Liability of Chairpersons Administering Departments 26

Liability for Acts of Partners 27

Hospital Liability for Acts of Physicians 27

Chapter 3 Standards and Practice Guidelines 31

American College of Radiology Standards 33

Departmental Standards 33

Legal Effect of Standards and Practice Guidelines 34

State Legislation 35

Chapter 4 Anatomy of a Malpractice Lawsuit 37

Prefiling Procedures 37

Formal Filing 38

Discovery 39

Deposition 40

Settlement Attempts 41

Pretrial Conference 41

Summary Judgment 42

Trial 42

Appeal 44

Chapter 5 Expert Witnesses 46

Availability 46

Role 47

Limitations 48

Qualifications 48

Consequences of Disqualification to the Witness 50

Proper Behavior of an Expert Witness 50

"Reasonable Degree of Medical Certainty" Standard 51

Practical Tips for the Radiology Expert Witness 52

Ethical Considerations 52

Adverse Consequences of Being an Expert Witness 52

Protecting the Radiologist from Being Falsely Accused by an Expert Witness 53

Chapter 6 Countersuits 56

Possible Causes of Action 56

What Should a Radiologist Do If Subjected to an Unjustified Suit? 57

Chapter 7 Alternative Dispute Resolution 59

Limitations of Formal Adjudication 59

Mediation 59

Arbitration 60

Alternative Dispute Resolution in Medical Malpractice 60

Chapter 8 Criminal Prosecution 62

Chapter 9 Professional Liability Insurance 64

Insurance Contracts 64

Occurrence Versus Claims-Made Policies 64

Tail and Nose Policies 65

Mandatory Insurance Requirements 66

Amount of Insurance Coverage 66

The Deep Pocket 67

Defense of Malpractice Claims 67

Settlement of Lawsuits 68

Chapter 10 Special Residency Issues 71

Insurance 71

Special Liability Status 72

Chapter 11 Reactions of Physicians Sued for Malpractice 74

Supporting a Sued Radiologist 75

Chapter 12 Role of the Radiologist-Defendant at Trial 78

Chapter 13 Risk Management 80

Communication with Patients 80

Part II The Missed Diagnosis: Overview

Chapter 14 The Missed Diagnosis: Overview 85

Frequency of Errors 85

Causes of Errors 86

Admitting Errors 91

Reporting the "Missed" Diagnosis 93

Defending the "Missed" Radiographic Diagnosis 95

Chapter 15 Interpreting Too Many Studies Per Day 101

Part III Communication and Records

Chapter 16 Radiology Reports 107

Comparison with Previous Examinations and Reports 109

Significant Discrepancy Between the Final and Emergency/Preliminary Reports 110

Signing the Radiology Report 111

Correction/Alteration of the Radiology Report 112

Chapter 17 Communication of the Radiologic Findings 115

Failure to Issue a Report 115

Delay in Issuing a Report 116

Direct Communication 117

Chapter 18 Release and Storage of Radiologic Images 123

Ownership of Images 123

Patient Access to Images 123

Confidentiality 125

Retention of Images 125

Storage and Destruction of Images 126

Chapter 19 Medical Records 128

Importance of Proper Medical Records 128

Correction/Alteration of the Medical Record 129

Adverse Consequences of Improper Alteration of Medical Record 129

Inappropriate Entries 130

Chapter 20 Confidentiality 132

HIV-Positive Patients 134

Part IV Radiology Practice and Specific Procedures

Chapter 21 Consent 139

Types of Consent 139

Informed Consent 140

Chapter 22 Do Not Resuscitate (DNR) Orders 149

Compliance with DNR Orders 150

Recommended Approach 151

Consequences of Failure to Comply with a DNR Order 152

Chapter 23 Barium Enema 154

Chapter 24 Breast Imaging 156

Risk of Women Developing Breast Cancer 156

Mortality Rates 157

Accuracy of Mammography 157

Effect of Mammography on Lengthening Survival Time and Reducing Death Rates 158

Effect of Delayed Diagnosis of Breast Cancer 159

Screening Versus Diagnostic Mammograms 160

Mammographic Errors 162

Reporting the Mammographic Study 162

False-Negative Core Biopsy of the Breast 164

Specimen Radiography 165

Tracking Patients with Negative Biopsies 166

Chapter 25 Interventional Procedures 172

Technical Issues 172

Postprocedure Care 173

Chapter 26 Ionic Versus Nonionic Contrast Material 176

Chapter 27 Sedation and Analgesia 179

Pediatric Patients 179

Adult Magnetic Resonance Imaging 181

Interventional Procedures 182

Chapter 28 Medical Devices 183

Off-Label Use 184

Informed Consent for Off-Label Use 186

Reprocessing and Reuse of Single-Use Devices 186

Chapter 29 The Pregnant Patient 189

Effect of Radiation Exposure on the Fetus 189

Determining Whether a Woman Is Pregnant 190

Examining the Pregnant Patient 190

Radionuclide Imaging 191

Chapter 30 Computed Tomography Screening Studies 193

General Criteria for Effective Screening 193

Radiation Risk 194

CT Screening for Lung Cancer 195

CT Screening for Coronary Artery Disease 196

CT Screening for Abdominal Pathology 197

Use of Contrast Material in Screening CT Studies 198

Medical-Legal Implications 198

Part V Electronic Imaging

Chapter 31 Teleradiology 205

Establishment of Physician-Patient Relationship 205

Medical Licensing and Insurance 206

Jurisdiction for Malpractice Suits 207

Other Medical-Legal Aspects 207

Relationship Between Local and Distant Radiologists 208

Chapter 32 E-Mail 210

Other Potential Problems with E-Mail 212

Chapter 33 Picture Archiving and Communications Systems (PACS) 215

Failure to Interpret "Lost" PACS Images 216

Part VI Governmental/Regulatory

Chapter 34 Credentialing and Peer Review 221

Due Process 221

Peer Review 223

Chapter 35 Infected or Substance-Abuse-Impaired Radiologist 226

Liability of the Infected/Impaired Radiologist 226

Liability of Other Parties 227

Informed Consent 228

Chapter 36 Federal Fraud and Abuse Enforcement and Compliance Plans 230

Fraud and Abuse 230

Compliance Plans 232

Documentation 235

Chapter 37 Professional Courtesy 237

Chapter 38 Sexual Harassment 240

Sexual Harassment Policy 240

Allegations of Sexual Harassment 241

What to Do If One Is a Victim of Sexual Harassment 241

Employer Course of Action 242

Chapter 39 Employee Retirement Income Security Act (ERISA) 244

Impact on Radiologists 247.

Notes:

Includes bibliographical references and index.

ISBN:

0387403094

OCLC:

52271655