title: Radiology Malpractice Claims in the United States From 2008 to 2012: Characteristics and Implications.
abstract: OBJECTIVE
  The aim of this study was to compare the frequency and liability costs associated with radiology malpractice claims relative to other medical services and to evaluate the clinical context and case disposition associated with radiology malpractice claims.
  
  
  METHODS
  This HIPAA-compliant study was exempted from institutional review board approval. The Comparative Benchmarking System database, a repository of more than 300,000 medical malpractice cases in the United States, was queried for closed claims over a five-year period (2008-2012). Claims were categorized by the medical service primarily responsible for the claim and the paid total loss. For all cases in which radiology was the primary responsible service, the case abstracts were evaluated to determine injury severity, claimant type by setting, claim allegation, process of care involved, case disposition, modality involved, and body section. Intracategory comparisons were made on the basis of the frequency of indemnity payment and total indemnity payment for paid cases, using χ(2) and Wilcoxon rank-sum tests.
  
  
  RESULTS
  Radiology was the eighth most likely responsible service to be implicated in a medical malpractice claim, with a median total paid loss (indemnity payment plus defense cost plus administrative expense) per closed case of $30,091 (mean, $205,619 ± $508,883). Radiology claims were most commonly associated with high- and medium-severity injuries (93.3% [820 of 879]; 95% confidence interval [CI], 91.7%-94.95%), the outpatient setting (66.3% [581 of 876]; 95% CI, 63.0%-69.2%), and diagnosis-related allegations (ie, failure to diagnose or delayed diagnosis) (57.3% [504 of 879]; 95% CI, 54.0%-60.6%). A high proportion of claims pertained to cancer diagnoses (44.0% [222 of 504]; 95% CI, 39.7%-48.3%). A total of 62.3% (548 of 879; 95% CI, 59.1%-65.5%) of radiology claims were closed without indemnity payments; 37.7% (331 of 879; 95% CI, 34.5%-40.9%) were closed with a median indemnity payment of $175,000 (range, $112-$6,691,762; mean $481,094 ± $727,636).
  
  
  CONCLUSIONS
  Radiology malpractice claims most commonly involve diagnosis-related allegations in the outpatient setting, particularly cancer diagnoses, with approximately one-third of claims resulting in payouts to the claimants.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: hbharvey@partners.org.
authors.forename: H Benjamin
authors.initials: HB
authors.lastname: Harvey
authors.affiliation: CRICO Risk Management Foundation, Cambridge, Massachusetts.
authors.forename: Elena
authors.initials: E
authors.lastname: Tomov
authors.affiliation: CRICO Risk Management Foundation, Cambridge, Massachusetts.
authors.forename: Astrid
authors.initials: A
authors.lastname: Babayan
authors.affiliation: CRICO Risk Management Foundation, Cambridge, Massachusetts.
authors.forename: Kathy
authors.initials: K
authors.lastname: Dwyer
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Sam
authors.initials: S
authors.lastname: Boland
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Pari V
authors.initials: PV
authors.lastname: Pandharipande
authors.affiliation: Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Elkan F
authors.initials: EF
authors.lastname: Halpern
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Tarik K
authors.initials: TK
authors.lastname: Alkasab
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Hirsch
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Pamela W
authors.initials: PW
authors.lastname: Schaefer
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Giles W
authors.initials: GW
authors.lastname: Boland
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Garry
authors.initials: G
authors.lastname: Choy
mesh_terms: D035881:Compensation and Redress / Q000331:legislation & jurisprudence*; D003951:Diagnostic Errors / Q000191:economics* / Q000331:legislation & jurisprudence*; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice / Q000191:economics* / Q000331:legislation & jurisprudence*; D011871:Radiology / Q000191:economics* / Q000331:legislation & jurisprudence*; D014481:United States
keywords: Radiology; damages; law; liability; malpractice; medical malpractice; policy; regulation