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Modern medical equipment is a lifesaver in giving appropriate therapy to patients. Following the development of radiology studies such as CT scans and MRI scans, physicians can precisely detect complicated issues inside the human body. Though many innovations are done consistently, misdiagnosis errors are unavoidable when considering CT scans vs. MRI scans.
According to a study published in 2019 in the Journal of the American Medical Association, there is a significant increase in the use of imaging studies from 2000 to 2016. Around 136 million imaging studies were done in adults and older adults. However, there was a drop in the studies done on child patients. Even though many physician groups are against the excessive use of CT scans and MRI scans, the trend is escalating.
Radiologist Leo Henry Garland (1903–1966) was a pathfinder in analyzing the diagnosis errors in radiology. He had done various analyses and found that even the most experienced radiologists could also make errors while comprehending and interpreting the radiology images. Various experts’ studies have helped reduce the errors in the most complex and error-prone imaging studies.
Here, we’ll probe at the procedures, applications, and errors of CT scans vs. MRI scans, as well as how misdiagnosis might exacerbate your pain and end up in medical malpractice lawsuits. Can you sue a radiologist for misdiagnosis? Read to know more about the causes of medical malpractice suits against radiologists in the United States.
CT scans vs. MRI scans
CT scans and MRI scans differ in their usage. Computer Tomography Scan or CT scan is the most sought-after medical diagnostic technology to get detailed images of muscles, bones, organs, and blood vessels. At the same time, Magnetic Resonance Imaging (MRI) is also non-invasive imaging used to get a more comprehensive picture of internal organs, tissues, and nerves.
How the patient undergoes the procedure also changes in CT scans vs. MRI scans. In a CT scan, the patient has to lie down on a tube-like machine, and it rotates to take a series of images. MRI machine has a more closed structure, making people with claustrophobia uncomfortable as they have to be inside for a long time. Moreover, the MRI machine produces more noise.
CAT scans vs. MRI scans vary in the use of the medium to capture the imaging. A CT scan or CAT scan uses multiple X-rays to various cross-sections of the body, and the computer assembles all the cross-sectional images and creates 3-D images. However, an MRI scan uses a powerful magnetic field to make the protons in the human body align with it. When the radio wave frequency is applied to the machine, the protons will work against the pull of the waves. When the waves are turned off, there will be a realignment of the protons. The time taken for that by the tissues will detect the defects in them.
The time taken for the procedure differs in CT scan vs MRI scan. A CT scan can be done in the shortest time, a maximum of 10 minutes. Whereas for an MRI scan, the patient should be inside the machine for more than 45 minutes.
In the case of an injured patient, a CT scan is ordered to diagnose the severity of his injuries and decide the plan of treatment, surgery, or other procedures. Since it produces a series of images of all the possible slices of the scanned part, it will be easy for the radiologist to see the injury in detail. MRI scans give clearer images of injuries in the spinal cord, nerves, muscles, tendons, ligaments, brain, knee, or shoulder.
While doing a CT scan, if needed, a contrast dye will be injected or given orally to the patient to get highlighted images of blood vessels, organs, or inner parts of the body. In case of getting contrast dye imaging, discuss your allergies or other health issues with the radiologist. During an MRI exam, dialysis patients are instructed to use gadolinium agents only if it is inevitable. However, they have to do dialysis to remove the agent entirely from the body as early as possible after the scan.
The risk of radiation is more when comparing CT scans vs. MRI scans. The ionizing radiation used during the CT scan is more than that of a normal X-Ray. The smaller amount of radiation from CT scans will not do much harm to people. However, prolonged exposure to ionizing radiation can lead to an increased possibility of cancer. People with metal implants like metal plates, pacemakers, nerve stimulators, defibrillators, loop recorders, cochlear implants, etc., should not undergo MRI scans as the magnetic field will have adverse effects on them.
The adverse effects of CT scans vs. MRI scans vary. As a CT scan is harmful to the fetus and can cause congenital disabilities, pregnant women or those who suspect pregnancy should inform the physician and radiologist about that. Pregnant women should avoid MRI scans only in the first trimester.
Common diagnosis errors the radiologists make
Misdiagnosis means making some errors in diagnosing the medical condition of the patient. What happens if a radiologist makes a mistake? If a radiologist read MRI wrong, it could be a setback for the patient to get proper treatment, and he would end up in a coma or dead. Failure to note down some minute findings in the CT scans or MRI scans is known as underdiagnosis. This also could delay the appropriate emergency care for the patient.
Every year, more than 40 million radiological misdiagnoses are recorded worldwide. Despite the invention of innovative technologies in diagnostic imaging studies, such errors could not be bridled. The inability to diagnose radiological images will potentially accelerate the damage to the patient.
Let’s explore the most common radiology misses that could arise on the part of the radiologists in diagnosing disease conditions in CT scans vs. MRI scans. Renfrew classification and Brook classification laid out the causes for the occurrences of imaging study errors.
Renfrew classification has listed out 12 types of diagnosis errors on the part of the radiologist as given below:
- Due to complacency, the deficit is found but related to something else
- Due to faulty reasoning, the abnormality found is attributed to something else
- Due to a lack of knowledge, the abnormality is related to the wrong cause
- Missing abnormality, which could be discernible in the revision
- Abnormality is not communicated to the concerned physician
- Abnormality could not be identified due to the poor quality techniques applied
- Failing to consider prior imaging studies
- Due to incomplete patient medical history, the abnormality can be missed
- Abnormality can be missed as it is outside the considered area.
- Missing an additional abnormality as being satisfied with one finding
- Error due to complicated procedures
- Relying blindly on the previous imaging report
Brook’s classification takes into account the technical errors, too, along with the radiologist’s errors. They are listed as:
- Human errors, such as errors in diagnosis and interpretation, the use of complicated procedures, and the involvement of more than one person
- Technical errors, such as system errors
- External elements like power failures
- Errors on the part of patients, like not obeying the instructions or others who are not familiar with the imaging procedure
How to restrict radiology errors?
Can MRI be wrong?/ can ct scans be wrong? MRIs and CT scans may not be wrong, but they can be read wrong. Do radiologists read MRI wrong? The radiologist who reads a ct scan or MRI scan must be extra cautious. CT or MRI errors happen due to a lot of reasons. While analyzing the prominent causes of misdiagnosis errors in CT scans vs. MRI scans, let’s place them under three categories to find solutions to keep them under check.
Perceptual errors from radiologists occur in the initial stage of reading the radiology images. It is one of the common errors in radiology. Fatigue is the main reason that could impact the errors on the part of the radiologists. The radiologists are working long shifts as there is an influx of imaging studies to be done and reviewed in a short time. According to a study, a radiologist gets only 3 to 4 seconds to review an imaging study. Workload and fatigue influence the performance of the radiologist in visual perception and diagnosis.
Radiologists should be given adequate break time to relax and refresh their minds to concentrate more on their reading images. Frequent quality checks at the department level and team meetings on recurring errors will mitigate them.
Artificial intelligence (AI) can be used to restrict perception errors. The AI algorithms read even voluminous imaging studies with complexities and recognize the abnormalities in a short span giving more or less qualitative reports. Modern advancements and powerful computing machines in AI research have been a boon to radiology, where perception errors are inevitable.
Longer shifts and higher examination volumes are associated with increased diagnostic error in radiology, says large study. Another reason to let #AI assist. https://t.co/ETFgmGCqv3
— Claes Lundström (@claesklar) December 15, 2017
Another method used to constrict the diagnosis errors is second or double reading. Reading the radiology diagnosis by a sub-specialist would definitely lessen the possible discrepancies that could arise from the initial report. However, a second reading is a time-consuming process, which could also lead to conflicting opinions. When we consider CT scans vs. MRI scans, a second reading can be implemented to confirm the finding in risky imaging studies.
While interpreting neuroimaging studies, radiologists follow heuristic techniques to assess complex findings in understandable formats. A biased approach to a diagnostic study would lead the radiologist to misdiagnosis or underdiagnosis. Approaching a study with a predisposed mindset would make the radiologist overlook an abnormality other than the one he was expecting.
Inadequate knowledge, failure to attribute findings to appropriate causes, complicated procedures, and blind reliance on prior findings and comparison to prior MRIs or CTs could lead to misinterpretation of findings.
The metacognitive psychological approach can be used to reduce interpretive errors. Radiologists should be skeptical during the review and analyze what had led to the abnormality in the finding. Using checklists to avoid missing common findings would be a reminder and restrict the diagnosis errors. Since the errors made by the radiologist who reads MRI scans or CT scans wrong can lead to irrevocable damage to the patients, utmost care should be undertaken when interpreting them.
According to National Center for Biotechnology Information, around 38% of the 380 communication errors in radiology directly affected the patient’s care. Failure to communicate the abnormalities in the imaging studies to the treating physician can exacerbate the patient’s condition to something fatal.
Suppose the patient’s past medical history and imaging studies come in handy to the radiologist from the treating clinician. He can be clear and vigilant as he knows what can be expected and what should be concentrated in the CT scans or MRI scans.
Reporting errors in radiology can be from the part of the descriptor while inferring the diagnosis and recording into the report. Defects in the communication medium could transfer false data and end up harming the patient. Therefore, effective transmission of diagnosis to the treating physician is inevitable in deciding on proper treatment plans and constructive progress in the healing process. Illegible handwritten imaging reports could mislead the treating physician and lead to the wrong treatment.
Misdiagnosis and medical malpractice
Are you in a dilemma about whom to sue for your suffering caused by a radiology misdiagnosis? You can definitely file a lawsuit against the radiologist who failed to diagnose a critical health issue or misdiagnosed one issue as another. Studies state that more than 30% of radiologists are sued at least once in their practice time. In most of the cases where the radiologists are sued, the reason would be underdiagnosis or misdiagnosis.
When we compare the first lawsuits in CT scans vs. MRI scans, we can understand the difference. The first lawsuit was filed for a CT misdiagnosis eight years after its invention of it in 1982, whereas four years after the introduction of MRI exams, the first lawsuit was filed in 1987. This fact shows that with the improving technology, the possibility of errors is also on the rise.
Bettina Siewert, MD, vice chair for quality and safety in the Department of Radiology at Boston’s Beth Israel Deaconess Medical Center, said, “If you are interrupted in the middle of reading a CT, you may forget where you left off and then forget to go back and look at something that you would have seen if you were not interrupted.”
Since imaging studies involve complexities, mild errors cannot be evaded. However, when a major error occurs due to the negligence of the radiologist ending in irreparable damages to the patient, there arises the necessity for a medical malpractice lawsuit. In the U.S. healthcare setting, diagnostic errors are 14% and surpass the medication error, which is just 9%.
Radiology mistakes can be averted, as suggested by Dr. Adrian Brady, the Chair of the European Society of Radiology (ESR) Quality, Safety & Standards (QSS) Committee.
Adrian Brady’s sagely advice on reducing error in radiology, given at the recent #REALM @RCRadiologists meeting pic.twitter.com/N9WMIK29ik
— Paul McCoubrie (@PMccoubrie) November 22, 2021
CT scans vs. MRI scans lawsuits
How could misdiagnosis tumble one’s life upside down? Can you sue a radiologist for misdiagnosis? Let’s see the answers to these questions through a few examples where people’s destinies were rewritten due to radiology errors.
A man who had cancer on his spine was treated with surgery and chemotherapy and was recovering. CT scan was done to monitor the healing as well as the possibility of regrowth of cancer cells. The radiologist ignored a very small lump and declared the CT normal. When the next CT was done after a few months, the lump had doubled in size. The subsequent surgery could not protect him from permanent disability. This stands as proof of what could happen if a radiologist read the MRI wrong.
In another case, a 60-year-old woman underwent a cervical MRI. She was allergic to certain medications. Though she had informed the technician about the allergic issues, she was injected with contrast dyes. The woman had breathing trouble and tachycardia and ended up in cardiac arrest and death. This proves how CT scan errors derailed his life.
These examples show how tragic a simple radiologist misdiagnosis or other radiology errors could toss people’s lives upside down. However, the only hope that was left to the victims was lawsuits. In the first CT scan contrast lawsuit, the victim received $5,000,000 as restitution, whereas in the second case, the victim’s family was awarded $7,000,000 as compensation for wrongful death for the error in the CT scan with contrast lawsuit.
Watch this video to know what happened when a radiologist read the CTs wrong,
If you are affected by a medical error from your radiologist, seek the help of a medical malpractice attorney to sue the radiologist.
Statutes of Limitation for Medical Malpractice
Knowing the statutes of limitation for filing a medical malpractice case is also important for making your claim strong. To proceed with your claim, check the table below for the time limit in your state and consult a well-experienced medical malpractice attorney.
Liability in Radiologist Lawsuits
Many radiologists, doctors, and most courts in the country rely on the American College of Radiology’s set of standards (ACR). The ACR states unequivocally that their “Practice Parameters are not intended to be legal standards of care or conduct.” However, when determining whether or not a radiologist violated the profession’s standards, judges and juries frequently differ from the American College of Radiology’s erudition. The ACR also publishes standards for radiologists who serve as expert witnesses in medical malpractice cases.
A radiologist malpractice claim takes four factors into account: 1) The radiologist owed the plaintiff a standard duty of care. 2) The radiologist failed to meet the established standard of care. 3) The violation of standard care resulted in a new or exacerbation of the plaintiff’s injuries. 4) The radiologist’s negligence directly caused the damages such as physical harm, medical expenses, and loss of income.
The radiologist is responsible for the medical discrepancy. However, if a miscommunication between the treating physician and the radiologist caused harm, the burden of standard care would be considered when determining liability. In that case, the treating physician or the radiologist would be held liable, depending on the burden of standard care. In some cases, they will share liability and pay a portion of the settlement to the plaintiff.
With the assistance of a medical expert witness, you can demonstrate that the missed diagnosis could have been detected by a skilled radiologist. Then you can try to convince the judge that the radiologist failed to provide the standard of care expected of a competent radiologist, and you’ll win the case in no time.
Radiology errors in CT scans vs. MRI scans cannot be overlooked as imaging studies have vital roles in diagnosing health issues and planning the treatment course. Delayed diagnosis or missed diagnosis can lead to irretrievable damage to the patients. The affected victims can pursue medical malpractice claims against the radiologist.
Expert witnesses use their experience and knowledge to decide if a radiologist has diagnosed a deficit even before the imaging study report is made. The degree of disability or injury caused by the misdiagnosis would decide if the radiologist was negligent. A well-experienced medical malpractice lawyer could lead the victims through the complex litigation process.
With innovative inventions in radiology, incessant efforts are made to mitigate the frequency of errors in reading imaging studies. Radiology reports cannot be error-free 100 percent, but the errors could be considerably curbed if more care and expertise are used.
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