AJR Podcasts Duty to Effectively Communicate: AJR Podcast Series on Diagnostic Excellence and Error, Episode 7
Dec 26, 2024
Jonathan Mezrich, an emergency radiologist and associate professor at Yale with expertise in medical legal issues, joins Francis Deng in a riveting discussion on communication in radiology. They delve into how communication failures can spark legal troubles, especially in malpractice cases. The evolving standards and guidelines set by the ACR are explored, as well as the pitfalls of digital communication. Additionally, they consider the transformational impact of direct communication with patients under the 21st Century Cures Act, emphasizing clarity and engagement to mitigate risks.
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1970s Legal Cases on Duty to Communicate
- In the 1971 case Keene v. Methodist Hospital, the radiologist failed to personally communicate a skull fracture seen on an X-ray during a holiday, resulting in patient death.
- Courts held radiologists liable for not following up directly with the treating physician in urgent or critical cases.
ACR Communication Categories Defined
- The ACR separates communication duties into routine and non-routine categories, with non-routine requiring expedited methods.
- Non-routine findings include urgent intervention needs, discrepant interpretations, and unexpected significant findings like cancers.
Missed Colon Mass Case and Settlement
- A radiologist detected a suspicious colon mass but after failed immediate contact, relied on electronic queue and report fax to urologist.
- The urologist missed the critical finding, leading to a metastatic cancer diagnosis 19 months later and a $4.5 million settlement.