medical malpractice against MD

RN2B2005 · Jan 26, 2003

I work in radiology. I currently work in an outpatient clinic but have previously worked in a hospital. I do transcription and coding now, but have also worked as a radiology assistant in CT, MRI, and interventional radiology.

In my experience, the referring physician's name--the doctor who ORDERED THE EXAM--is at the top of the order and also appears in the salutation ("Dear Dr. So-and-so") at the top of the page. Even if the patient specifies that another physician is to give her the results of the exam, the ORDERING physician's name appears at the top of the page, and any physicians to be copied in are listed at the bottom. This is true for ANY sort of radiological exam.

If your insurance company was billed for the CXR, the EOB will likely show the radiologist's name, not the ordering physician's name. However, when the claim is submitted to the insurance company by the radiology office, the radiology office is REQUIRED to provide the name of the ordering physician, in addition to the name of the radiologist who read your exam. So, if you obtain the original claim submitted by the radiology office for the CXR, you will find the name of the ordering physician.

Most radiology exams, with the exceptions of some ultrasound, interventional and breast imaging exams, are INTERPRETED by the radiologist but the radiologist does not give the results directly to the patient. This is because in most cases, the radiologist will have no role in the follow-up care of the patient.

Finally--I know this can't help you now--it is the responsibility of the PATIENT to follow-up on exam results. Don't assume that silence equals a negative result. Doctors today have literally hundreds of patients, and while this doesn't excuse what happened in your case, it does explain it. You saw your doctor multiple times after the first CXR--did you ever directly ask him for the results of the exam?

In addition, it is not uncommon for a CXR to look 'clear' on first exam, and then, when compared with a later CXR, to show retrospective evidence of malignancy. CXR's are not the best way to screen for lung CA--high speed noncontrast CT scans of the lungs are more reliable in most cases. So, it may have been that your first CXR did not cause any alarm and was read as normal--you'd have to read the original report and not the report from the second CXR (the report that listed a comparison film).

Ask your attorney if he or she saw the ORIGINAL CXR report from the FIRST exam. If she did see it, ask her if the physician's name was on it. If it was, then you should ask your attorney why the doc was allowed to debate the fact that he ordered the exam. You might find another attorney.

Good luck.

hoolahan, ASN, RN · Jan 26, 2003

RN2B2005, interesting info. I do very strongly disagree that it is the pt responsibility to f/u on pre-admit testing, which is basically what this was. She was going to the doctor , I assume since she did not answer what the first surgery was for, a different kind of surgery (we can presume I guess that this doctor was not a CT Surgeon.) Everyone is made to feel like the pre-admission testing is "just routine", and if the sugrery did not involve her lungs or chest, why would she have ANY reason to suspect there was a problem??

He ordered routine Pre-admit testing if over a certain age inc CXR.

He should not do surgery if he does not even read the results of these reports. He is figuring that when anesthesia does their pre-op review, they will pick up on the problem. It is lazy and inexcusable.

My husband had a laminectomy in 97, inc'd a CXR pre-op. In 99, he had another lami, at which point we were surprised that the anesthesiologist asked my hubby how long he had had emphysema?? What?? He said, well it does show you have early lung disease, but it is essentially unchanged from the CXR in 97. Suprise! No one said a thing about the CXR in 97!! If he stopped smoking two years earlier would this have changed his life?? Probably not, but if he had been informed, he may have quit smoking.

The bottom line in any law suit is was there negligence and was the harm done? Yes it is clear he was negligent, but whether the outcome would have been diff if your lesion was ID'd, treated, etc at the time of the first x-ray is not clear from what you have told us here.

I say pursuing a civil suit may be your best course of action. He should admit he was wrong and owes you an apology at the very least!!!

mattsmom81 · Jan 26, 2003

Doctors manage to worm out of so many liability situations like yours. It makes me sick.

I have a girlfriend whose breast mass was mammogrammed and ultrasounded for years...she was reassured it was benign. Then she 'felt' the lump was different somehow...and demanded a biopsy. It was cancer and she had to go through the whole chemo/lumpectomy thing. She was told my an attorney she had no case. I was floored. She only had the biopsy because SHE insisted!!!! The delay may have allowed mets and is still to be seen whether this happened or not.

Hope you got a somewhat decent settlement out of this at the very least...and hope you are now cured after your lobectomy. Best wishes for good health!

niteshiftnurse · Jan 26, 2003

i was told my survival rate was 81%. i was also told if it came back, it would go to bone, brain, lung, liver and adrenal gland. it has ben 3 years and so far....so good.

DIPLOMATICRN4HIRE, MSN, RN · Jan 26, 2003

If you have settled the suit then basically you decided to end further investigations... However.... Did you file a complaint against the Dr himself with the Medical Board Association? If you have not do so, and now. But you may want to speak with with your lawyer prior to doing it because it may depend on what you signed on the settlement. There is a chain to the paperwork, it will just take some serious digging to locate it... and they will by no means make it available for you. If there was an order and it was completed there is a charge.... locate that charge and work back, if its even still there, the hospitals have a mysterious way of having things disappear... I know I found it amazing on what the gremlins at the hospital ate when I went through my lawsuit against a Dr. The Medical board will be lax on the Dr's , especially when it comes to the "Good Ole Boys" and when they need a helping hand with each other. Its a shame... but it happens all the time. Your best bet is to just see if you can file a complaint with the Board of Medicine, so there will be a paper trail with the God forbid "next case", which wont assist you in anyway but will help the next poor soul sitting in the shoes you once wore.

I do hope that you have a fullfilling life and you are able to walk away from this and enjoy your life.

Zoe

niteshiftnurse · Jan 27, 2003

Zoe,

Do I have to go thru my atty????, or can i just call the medical board myself.

sunnygirl272 · Jan 27, 2003

Originally posted by angiebruno
Sunnygirl 272

I had a right upper lobectomy done after i found out

no, my question was what surgery did you have initially that led to the initial CXR....

niteshiftnurse · Jan 27, 2003

surgery on my arm

DIPLOMATICRN4HIRE, MSN, RN · Jan 27, 2003

Check with your lawyer first because it depends on the contract you signed that prohibits other actions to be taken . If there is nothing in the contract that states NO you can not contact the Medical Board,the press, IE: other institutions that will leave a paper trail . Then you can. If there is a clause then you basically have chosen to accept the conditions of the signed contract, unless you wish to return the settlement and start from scratch again and also give him a doorway to sue you as well. SO check with your lawyer if its is stated anywhere in the clauses of the settlement.

Zoe

moonrose2u · Jan 27, 2003

1) file a written complaint with your state's medical board (send it certified and return receipt

2) write either "Dateline" or "20/20" or "60 minutes II" and tell them you just want other people to avoid the same mistakes happening to them....boy, oh boy, if one of these media mags gets ahold of your story..its over for the doc..