Well this is fun

[SoonerTexan]

http://www.bostonglobe.com/metro/201...VSL/story.html

That's a lot of $$$

[Curegirl]

[Sheherezade]

So, when you hear hoofbeats, think horses.....but make sure you MENTION zebras. Remember it could always be zebras!!!

[PrincessFiona]

Two words: malpractice reform

[MrsC]

Two words: malpractice reform

Yes!

Articles like this make me sick.

[spaz]

Welcome to our world.

[ladymoreta]

But don't forget to complain if you have to wait more than 24 hours to see a specialist or get your test results. There must be enough doctors available to accommodate everyone immediately. No, we don't really want to pay them, though. Isn't that what taxes are for? Freaking rich, whiny doctors...

[Meenah]

AND she smoked for thirty years!!!!!!!!!!!!!!!!!!!!!!!!!

[rain_dancer]

Cases like this are, I think, one of the main reasons (if not THE main reason) healthcare costs in this country are so high. Physicians are forced to practice "CYA" medicine, which results in innumerable unnecessary and expensive tests/scans, not all of which are without risk to the patient. The take away message to radiologists: always mention zebras, even if they're the of the neon pink and green striped variety. The take away to physicians ordering those scans: don't use your clinical judgment based on your more detailed knowledge of the pt and their medical history and current symptoms to determine if follow-up testing is needed based on the radiologist read, because a needle in the haystack *might* get missed and then you'd be liable. Sheesh!

Everyone suffers when they lose someone they love, perceived malpractice or not. No amount of money will change that, and I don't understand that disconnect in our legal system (or maybe culture in general...).

[HouseofWool]

I guess my takeaway is slightly different, having lost 2 grandparents to cancers that would have been caught earlier had appropriate care been rendered right away. Both were readily diagnosed on x-ray, and would have been in the early stages as well. I'm still angry/saddened about it a dozen years later. For a YEAR my grandmother's back pain was incorrectly diagnosed as being musculo-skeletal, when in fact her entire body was riddled with cancer, her entire lumbar spine and most of her long bones were full of tumors, as was her abdomen. As simple repeat x-ray would have given us more quality time with her.

Yes the award is stupid high and is a small part of why our healthcare system is broken (insurance companies being the major reason), but in reading the case, it sounds like a follow up x-ray should have been taken after her respiratory infection was gone to ensure that the opacity had cleared. What isn't clear is the patient's compliance with follow up. If she didn't return to her PCP for f/u care, I don't think the onus lies with the radiologist.

[SoonerTexan]

There was one article that mentioned this:

Murray said Clarke was able to see areas of opacity in the chest X-ray when he reviewed it after Ellis’ cancer diagnosis, but those areas could have been attributed to a number of things, such as tissue structures or other organs.

I'm guessing the argument was that there was nothing on the original scan to indicate there really was a problem that should be addressed.

[HouseofWool]

There was one article that mentioned this:

Murray said Clarke was able to see areas of opacity in the chest X-ray when he reviewed it after Ellis’ cancer diagnosis, but those areas could have been attributed to a number of things, such as tissue structures or other organs.

I'm guessing the argument was that there was nothing on the original scan to indicate there really was a problem that should be addressed.

That is the part, to me, that indicated that a f/u set of films was warranted. If there was an opacity and she had an infection, it seems like it would be a good idea for her PCP to order a set of repeat films after the infection had cleared, especially as the PCP would have known that she was a long term smoker. But, in no way should the responsibility be on the radiologist for this. Although, I do think it would be important to read the rest of her chart before reading the film. In which case, his report probably should have noted the opacity and said something to the effect that should be re-evaluated after her infection resolved.

[Sheherezade]

This is why I favor malpractice cases being reviewed by a panel of physicians in the specialty and awards decided from there. I don't think any group besides a group of peers could determine if this was faulty care, patient non-compliance or just bad luck.

The argument against is that doctors would just protect each other, but I don't agree. Nothing gets my husband angrier than seeing a patient that should have received care a year ago.


Angie

[SoonerTexan]

DH wanted to see the Xray! I asked him about reading the chart. Obviously his experience is limited to a rotation and he wont get into it until next year, but said the thought seemed to be reading the chart in advance could bias your reading. (ie you'd be focused on looking for X and might miss something else). I'm curious as to how often charts come into play at all. No idea.

[HouseofWool]

I understand that knowing the history could bias how a film is read, but knowing she was a smoker is kinda crucial, particularly for a chest xr. Just like knowing someone is diabetic or a hemophiliac is important for surgeons.