iRADiX

Do you communicate two ways when confirming a critical report? Or do you write a report and file it in the dispatch section and say “I am Done.”?

Mock Jury Trial: The Case

The recent RSNA 2009 Mock Jury went on trial on the assumption of breech of standard of care. The radiologist saw a suspicious shadow in right upper zone on the X-ray Chest, wrote that he needed CT examination to evaluate this area further and even faxed the report to the Emergency department. However, the Emergency physician had read the X-ray Chest as normal and somehow the radiologist report was not read, though it was in the files.

After 20 months the lady came with a chest mass and the radiologist was brought to trial for “Breech of Standard of Care”.

Guidelines of Community of Peers

The Emergency department sees hundreds of reports every day. Hence a radiologist should communicate a non-routine report, should know the preliminary report of the emergency physician and should file the Discrepancy report.

It is not only a case of Egos. Missed diagnosis can later land in courts.

Even not having suggested a particular differential which later proved right on follow-up or staging which was completed after inputs from different knowledge sources can be used by lawyers who want to prove their case. This is a world of Half-truths.

When there is no clear written policy, power relations tend to decide priorities.

Buy a tie?

One day a radiologist saw his friend come to the centre and discussing something deeply with the partner-radiologist.

What is he doing here?  Knowing the background of their relation and to put it diplomatically, things were not the same as before between them, it was rather unexpected to have him in the centre which he toiled to establish.

How do you deal with Missed Diagnosis? Are there Medico-legal aspects of our work, which we are not wholly aware of or ill-equipped to deal with?

Do not laugh

Oh! He ran away from the back door, one ‘good-friend' laughed over the phone over the predicament of a fellow-radiologist.

Do not laugh! If it can happen to such a senior and influential radiologist, think where one of us lesser mortals will be if faced with a similar ugly situation.

Beyond Egos.

Apart from the ego aspect of having missed something, or not having suggested a particular differential which later on was proved right after follow-up and pathological correlation, there are many procedures which are done in the Radiology department which can be challenged legally.

Do not get scared by anyone if you are following all the rules as per the PC-PNDT law.¹. This is an interesting guideline. Is there reason to be scared? If not, why this guideline? Have you been unfairly intimidated?

Just another case

Upside down: Corrupt interpretations

"For them it is just another case" he said with a resigned note when his friend asked him about his confiscated machine.

"This is life, and in life, one has to face many challenges," he continued, in a philosophical tone, and would sometimes even start falling back on the "Karma" theory which binds the life of Hindu civilization.

“The Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act.”

“An Act to provide for the prohibition of sex selection, before or after conception, and for regulation of pre-natal diagnostic techniques for the purposes of detecting abnormalities or metabolic disorders or chromosomal abnormalities or certain congenital malformations or sex-linked disorders and for the prevention of their misuse for sex determination leading to female foeticide and for matters connected therewith or incidental thereto.”

* This article is for our Indian audiences.

Must be read by every Radiologist who performs Obstetric Ultrasound.