0:00

So this is a recollection by a radiologist

0:05

who was sued for the first time in the career.

0:08

And, and, and what I'm going to tell you is, is I,

0:11

I got in touch with, uh, that person,

0:14

and this is verbatim that he told me

0:19

and wanted me to share with all of you as to what happened,

0:23

uh, during the course of the lawsuit

0:26

that he was involved in.

0:28

So, uh, it went like this.

0:31

He got, gets an email, the subject line is medical, legal,

0:35

uh, negligence claim,

0:36

and its cases from six years ago from, uh, the lawyers,

0:41

uh, that were involved in the case from the

0:43

plaintiff's side.

0:45

So he said that he started to feel nauseous right away

0:49

as he was reading that letter

0:51

and just wanted to run away from the hospital

0:53

as fast as he could.

0:56

Uh, his, his bowel stopped working.

0:59

I don't know what that's really supposed to mean.

1:02

Uh, so the next thing he does, so the next day he did not go

1:06

to the hospital because he was so depressed

1:09

that he didn't want to come out of the bed

1:11

and continuously kept on thinking about, uh,

1:15

this, this case.

1:17

Uh, but the day after he goes to the case manager

1:20

and the risk management in his, uh, hospital,

1:24

and they ask him that, do you remember the case?

1:27

And they said, asked him what the,

1:30

my mental state was in the last couple

1:32

of days since this notice was, uh, served to him,

1:37

and did he wake up 3:00 AM worried about this case,

1:40

and did he have any self doubts about his ability, um,

1:45

to be a radiologist?

1:47

And, and, um, most of the answers were yes, uh, yes,

1:50

because that's exactly what happens when you, when you get

1:54

that letter first time in, in your hands, that you,

1:58

you start to have self-doubts about your ability to being,

2:02

uh, being a radiologist.

2:04

And, and because we sometimes hold our, we most

2:07

of the times hold ourselves to a very high standard of care.

2:12

So the case goes like this.

2:14

It's a 46-year-old with upper arm radiculopathy.

2:18

The scan was ordered by a neurologist, and here is the scan.

2:23

Uh, and these are images from the real scan that was shown.

2:26

And as you can see that there is, uh, C five six, uh,

2:30

moderate to severe cord compression,

2:32

depending upon whether you are a under color and over color.

2:35

There is some cord signal abnormality there.

2:38

And of course, there is some foraminal stenosis, again,

2:41

moderate to severe based on, uh, what your preference is.

2:45

But the point is that there is good bit of cord compression

2:48

and good bit of foraminal stenosis responsible

2:51

for this patient's, uh, upper arm radiculopathy.

2:56

So reported moderate

2:58

Cord compression with mild focal edema at C five six.

3:02

No one, no one can challenge that.

3:04

The accuracy of the report was never in the

3:07

dispute In this case.

3:08

Uh, patient was had bad outcome

3:13

as surgery was delayed for about six months from the time

3:18

that the MR was, uh, opined on

3:23

and, uh,

3:25

the whole case against the radiologist.

3:28

There were other people also in the case,

3:30

but against the radiologist, it was attributed to the fact

3:33

that the report was not called through

3:37

to the ordering physician, and it was the, an type report

3:42

or I mean, uh, type report scanned on a Friday,

3:46

reported on Saturday, and the fax was

3:49

delivered on on Monday.

3:53

Uh, so when the co uh, the case went, uh,

3:57

and was discussed upon,

3:59

and the plaintiff had their medical legal expert opine on

4:03

the case, the medical legal expert on the side said that

4:09

based on what he

4:11

or she is seeing, uh, this non-routine communication

4:16

of the finding, the doctor,

4:18

referring doctor should have been, uh, called

4:22

and should have been made aware of

4:24

because this is a significant, uh, finding.

4:28

So that was the, and, and that's

4:30

what brought the case into the legal foray,

4:33

and it was pursued upon based on, on that fact.

4:37

Uh, now the defendant, medical-legal experts, both radiology

4:42

as well as neurosurgery

4:43

and actually three neurosurgeons were sought.

4:46

Uh, and, and, and,

4:48

and all of them had this clear impression that, okay, the,

4:52

the, the, the scan was read the way it should have been

4:56

read, uh,

4:57

and all the three neurosurgery, uh, neurosurgeons opined

5:02

that this is not something

5:05

that they would expect a phone call from the

5:07

neuroradiologist or for that matter, a general radiologist

5:11

who is reading the case,

5:12

because this is an ongoing chronic process

5:16

and it will gradually worsen with, with time.

5:19

So there was no acute injury that need to be called out at

5:24

that at that time point.

5:25

So, uh, but he,

5:27

nonetheless, the ca case, uh, went to deposition

5:31

and all the oles that are involved with, with the case.

5:34

But finally, the final opinion for the radiologist was

5:37

that a radiologist was, was dropped from the case

5:40

because, uh, the, actually the neurosurgeon

5:43

who ended up doing surgery also said the same thing that,

5:47

uh, it's not, it's not usual for them

5:50

to get a phone call from, uh, their radiologist, uh,

5:54

about, uh, such a case.

5:55

So, but nonetheless, it took about 3.5 years

6:00

from the start to finish with the radio where the, this, uh,

6:04

radiologist ha was, was withdrawn from the case.

6:08

Imagine the physical and mental anguish

6:11

and many sleepless nights and anxious days.

6:13

This is, these are ha the exact words

6:16

that the radiologist shared with me that he went through

6:19

during all this time.

6:20

And the self-doubt he had, didn't, didn't, couldn't talk

6:25

with most of, most of the people that were

6:27

around him, his friends.

6:28

And because obviously you can't talk

6:30

to your colleagues in radiology.

6:32

So, uh, even though the case had favorable result

6:37

for the radiologist,

6:38

but 3.5 years he had to go through this.

6:41

So you can, you can well imagine the toll that a case such

6:45

as this can take, and in this, in this case, I, I feel

6:49

that the medical-legal expert

6:52

opinion was not really objective.

6:55

And, and,

6:56

and the, the, the, the point that he was trying to make

7:00

that this type of finding should be called,

7:02

if this happens in real world

7:04

and all of, I'm pretty sure all of you have seen cases such

7:08

as this, if we start doing this, we'll be probably making 10

7:11

to 12 phone calls a day, uh,

7:13

to our neurosurgery colleagues about such cases and, and,

7:16

and, and they will not even want

7:18

to pick up our phone after that.

7:19

So, so I think there was a slight deviation from the

7:23

standard of clinical care when it was suggested

7:26

that such phone calls should be, should be, uh, made.

7:30

And, um, we'll, we'll talk about the medical-legal expert,

7:34

uh, duty, uh, later on in this talk.