Articles Posted in Radiology Errors

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Thirty-two-year-old Regina Ruff came to the emergency room at Advocate South Suburban Hospital in the morning on July 14, 2007 complaining of shortness of breath. Ruff had a history of congestive heart failure, hypertension, diabetes and non-compliance with the taking of some of her medicine.
At about 11:45 a.m., the emergency department doctor, defendant Sharon Smith, M.D., examined Ruff and ordered tests. That included lab, chest x-ray and EKG.

The chest x-ray that was done at 12:15 p.m. was interpreted by a radiologist at 12:30 p.m., suggesting bilateral pneumonia. Dr. Smith’s review of the chest x-ray films was indicative of both pneumonia and congestive heart failure. The lab results showed an elevated white blood count consistent with infection like pneumonia and elevated BNP (B-type Natriuretic Peptide), which is a substance secreted from ventricles or lower chambers of the heart that show pressure increases. These occur when a person has heart failure.

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Radiation has been a great boon to medicine, helping doctors reveal hidden problems, including broken bones, lung lesions, heart defects and tumors. It can be used to treat and sometimes cure certain cancers.

Now researchers are pointing to its potentially serious side effects: the ability to damage DNA and, 10 to 20 years later, to cause cancer. CT scans alone, which deliver 100 to 500 times the radiation associated with an ordinary X-ray and now provide three-fourths of Americans’ radiation exposure, are believed to account for 1.5 percent of all cancers that occur in the United States.

Numerous experts, including some radiologists, are now calling for more careful consideration before ordering tests that involve radiation.

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A new study shows that white children are more likely than black or Hispanic children to receive CT scans following minor head injuries, exposing them to the dangers of excess radiation.

The study was conducted by Dr. Prashant Mahajan of the Children’s Medical Center of Michigan and other researchers.

The Archives of Pediatrics & Adolescent Medicine reported the results of the study in an article titled, “Cranial computed tomography use among children with minor blunt head trauma: Association with race/ethnicity.”

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In many medical malpractice lawsuits, plaintiffs are critical of physicians for failing to make proper referrals or diagnose a condition in a timely fashion. However, if the patient does not keep appointments or take some responsibility in their own care, then it is difficult to find fault with the physician.

In the Illinois medical malpractice case of Melissa Brooks, Loren Brooks v. Surendra Gulati, M.D., 08 L 838, the plaintiff was critical of her physician, Dr. Gulati, for failing to diagnose a vascular tumor in her spine. Brooks first presented to Dr. Gulati in January 2002, at which point she relayed that she had been having back pain, tingling, and numbness for the past several months.

In response to these complaints, Dr. Gulati referred Ms. Brooks for an MRI of her lumbar and thoracic spine. He then conveyed the radiology results to her over the phone – the report suggest a possible arterial venous malformation, or a possible benign spinal tumor. In order to follow up on these findings, Dr. Gulati claimed he ordered an additional MRI of Ms. Brooks’s brain and scheduled a follow up appointment.

However, the 27 year-old Brooks did not follow through with the additional brain MRI, nor did she show up for her scheduled visit with Dr. Gulati. This missed visit was at the center of Brooks – the plaintiff contended that Dr. Gulati should have contacted her after the missed appointment, whereas Dr. Gulati contended that he had acted within the standard of care and was not responsible for making sure Ms. Brooks kept her appointments.

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Medicine is a healing profession; as patients we look to our physicians to cure our ailments and relieve our pain. However, in order to heal us, doctors must first diagnose the problem – a quick and speedy diagnosis is often the key to a successful recovery. Likewise, when there is an unnecessary delay in diagnosis, oftentimes the outcome is not very favorable for the patient.

Take for instance the case of 76 year-old Shirley Cyborski, who died as a result of the failure to diagnose her colon cancer for over a year. The medical lawsuit resulting out of this misdiagnosis of cancer, Estate of Shirley Cyborski v. Advocate Health and Hospitals Corp., et al, No. 08 L 6447, was recently settled for $2.05 million.

In 2006, Shirley presented to Advocate South Suburban Hospital for a barium enema examination. This exam is typically performed when a patient experiences a change in bowel habits, has abdominal pain or rectal bleeding, or if there is a suspicion that the patient has diverticulitis or polyps. An x-ray of Shirley’s colon was taken at the time of the barium enema exam, which showed a mass in her colon. However, the colon mass was not reported and therefore her cancer went undiagnosed.

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A $4.5 million settlement was reached between Advocate Christ Hospital and Medical Center and the family of a man who died after his bladder ruptured at the Chicago hospital. The claims in the wrongful death case of The Estate of Krzysztof Bialas v. Advocate Christ Hospital and Medical Center, No. 07 L 12141, were that the decedent’s death could have been avoided if the hospital’s radiologist had correctly read a CT scan that would have identified the problem.

The decedent, Krzysztof Bialas, was a 42 year-old warehouse worker who presented to Oak Lawn’s Christ Hospital with a fractured pelvis after being injured in a forklift accident at his job. Nursing notes from the hospital visit indicated that Bialas’s scrotum was extremely swollen. In response to this observation, doctors ordered a CT scan of Bialas’s abdomen and pelvis.

While Bialas’s fractured pelvis was appropriately diagnosed by x-ray, the radiologist failed to recognize the presence of a large amount of fluid in Bialas’s pelvic area. The medical malpractice complaint filed by the decedent’s estate alleged that it was this radiology error that ultimately led to Bialas’s death.

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Radiation therapy is a common treatment for a large range of cancers and has been responsible for saving, or at least extending, many peoples’ lives. However, the basic premise of radiation therapy involves targeting and killing cancerous cells in one’s body. And while properly administered radiation therapy can save lives, when hospitals and doctors administer too much radiation it can result in negative effects for the treating patient.

Overdoses of radiation is becoming more and more widespread amongst cancer patients. A recent report of Evanston’s Northshore University HealthSystem, a Chicago-area hospital, provided one such example. A 50 year-old mother of three was administered dangerously high doses of radiation when the hospital staff made radiology errors involving the administration of her radiation doses. The young Illinois resident went from an active, vibrant person pre-radiation to a virtual invalid post-radiation and now resides in an Illinois nursing home.

This woman was just one of three oncology patients who received an overdose of radiation at Evanston Hospital. All three instances of the radiation errors were allegedly the result of faulty linear particle accelerators. These accelerators are used to focus the radiation on the cancerous cells and are commonly used for stereotactic radiosurgery (SRS).

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Several studies have recently investigated the dangers of different radiology scans and the possibility of radiation overexposure. While many of these radiology scans are important diagnostic tools, research has suggested that many physicians are unaware of the dangers of several different scans, or else are poorly informed about the inherent risks.

Radiology scans are an important tool in screening for breast cancer and allowed physicians to diagnose breast cancer much earlier, thereby increasing the cancer patient’s hope of survival. However, depending on the type of radiology exam used the degree of radiation exposure varies drastically. For example, a typical mammogram increases a woman’s risk of developing breast cancer by 1.3 times per every 1,000 women.

A mammogram is the standard diagnostic exam to diagnose breast cancer, however, there are additional radiology exams that doctors might order if the mammogram fails to provide a clear diagnosis. Of of these exams, the breast-specific gamma imaging (BSGI) increases a woman’s risk of developing breast cancer by 20 to 30 times and the positron emissions mammography (PEM) increases the risk by 23 times. Also, while radiation exposure during a traditional mammograms only increases the risk of developing breast cancer, the BSGI and PEM also increase the risk of cancer in other major organs, i.e. the bladder, gallbladder, kidneys, etc.

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Oftentimes cancerous tumors are recognized in the process of investigating another medical problem. For example, a woman presents complaining of weight loss and an exam reveals breast cancer. Because early diagnosis of cancer can drastically improve the patient’s survival rate it is important that physicians capitalize on these opportunities.

In Tariq v. Naperville Radiologist, S.C., et al., 09 L 156, the plaintiff brought an Illinois medical malpractice lawsuit against Edward Hospital and its radiologist for failure to diagnose cancer. The plaintiff claimed that the radiologist had failed to comment on an area of abnormality in her abdominal area on a chest CT scan. The CT scan was being taken as part of the plaintiff’s screening for TB and was not told anything about the abnormal results.

Over the course of the next year the plaintiff began to experience weight loss and became fatigued. She returned for further workup, at which point a CT showed a 16 cm. abdominal tumor. In addition, the tumor had metastasized to other organs, including the spleen, stomach, pancreas, and colon.

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A recently published government report has sparked additional concerns regarding the risk of overexposure to radiation from unnecessary radiology scans. The results of the national report on medical imaging practices shows that Illinois hospitals provide double chest CT scans almost twice as often as other hospitals nationwide. A double chest CT scan is when a study is ordered both with and without contrast, which requires it to be done twice thereby exposing the patient to twice as much radiation.

One of the main hospitals cited in the report as potentially giving “patients a double scan when a single scan is all they need” is Edward Hospital, located in Naperville, Illinois. Edward Hospital officials were reportedly surprised to learn that their CT scans exceeded the national average and have since launched an investigation into its radiology department policies and procedures.

The new government reports on Edward Hospital and other medical institutions nationwide can be found at the government-run website Hospital Compare. This informative website allows patients to search different hospitals by region and compare the quality of care provided by each. Medical information websites like Hospital Compare allow patients to be their own medical advocate and make informed decisions about their care and treatment.

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