Radiology and the Law: Malpractice and Other Issues / Edition 1

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Overview

Practically every radiologist would benefit from an all-encompassing guide to malpractice issues in radiology. Dr. Ronald Eisenberg, a highly respected author in the field, has put together a comprehensive reference to provide radiologists with an introduction to malpractice issues and a basic understanding of their relationships with government regulatory agencies and HMOs. This softcover book will detail the mechanics of a lawsuit, how radiologists can become the object of a malpractice action, and what they can do to minimize potential exposure.

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Editorial Reviews

Doody's Review Service
Reviewer: Stan Zipser, MD, JD (University of Colorado Health Sciences Center)
Description: This is a book on legal issues involved in the practice of radiology.
Purpose: The purpose of this book is to educate the radiologist on legal issues encountered in the practice of radiology. More specifically, the author seeks to make radiologists aware of how they can "become enmeshed in the legal system" and offers suggestions on risk reduction. These are worthy objectives as almost every radiologist frequently considers the legal implications involved in practicing radiology. The book is moderately successful at introducing the reader to many legal issues surrounding the practice of radiology, and in particular, educating the reader at how they may encounter the legal system and practice risk reduction strategies.
Audience: The book is intended for the practicing radiologist and would be instructive for the radiology resident and fellow as well. Because it is a broad, easy to reference introduction to many legal issues surrounding the practice of radiology, this book fulfills the needs of the radiologist. The author is a well known diagnostic radiologist, but is less prominent in the legal arena.
Features: This book introduces many legal topics that a practicing radiologist may encounter. The book begins with legal theories behind a malpractice action, and then covers such topics as the anatomy of a malpractice lawsuit, professional liability insurance, the missed diagnosis, informed consent, subspecialty areas such as breast imaging, PACS and email issues. The book's strengths lie in its breadth of areas covered and its detailed table of contents making the subject matter easily referable. It is a good introductory book and starting place for the radiologist looking for a quick explanation of a legal topic; that is, it is most useful as a reference when a specific legal question arises. I see only the very interested radiologist reading the book cover to cover. It is not an authoritative text on legal medicine. The book has weaknesses. First, the writing is at times incoherent. For example, the section dealing with vicarious liability issues of technologists - an important topic - is muddled and impossible to understand as written. Secondly, the book is sometimes incomplete from a legal point of view. For example, when discussing defenses against a claim of the missed radiographic diagnosis, the author does not mention one of the basic defenses against such a claim: namely, did the missed diagnosis cause an injury to the plaintiff patient? While the book does not purport to be a definitive text on medical malpractice, it sometimes even fails to provide the basic background of the topics the author chooses to address. Finally, the author at times relies too much on the work of Dr. Leonard Berlin. Some chapters are only a recapitulation of what Dr. Berlin has written in previous articles.
Assessment: This is a well organized and practical introduction to legal issues a radiologist encounters. It is a good book to refer to for a quick review of many legal topics. It falls short at times, however, in articulating even basic legal theories behind the topics introduced. It is better organized and slightly more authoritative but a little less engaging than Dr. Berlin's articles and books addressing radiologists' legal issues. There are countless articles and books on medical malpractice in both the medical and legal literature that cover the legal topics of this book better and more thoroughly, but this book is somewhat unique in that it is geared toward the radiologist.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780387403090
  • Publisher: Springer New York
  • Publication date: 11/14/2003
  • Edition description: Softcover reprint of the original 1st ed. 2004
  • Edition number: 1
  • Pages: 265
  • Product dimensions: 9.21 (w) x 6.14 (h) x 0.60 (d)

Table of Contents

I Malpractice Litigation.- 1 Malpractice.- Duty.- Breach of Duty.- Injury (Damages).- Causation.- Res Ipsa Loquitur.- Defenses and Limitations to a Malpractice Suit.- 2 Vicarious Liability.- Employees Versus Independent Contractors.- Liability for Acts of Technologists.- Liability for Acts of Residents.- Liability of Chairpersons Administering Departments.- Liability for Acts of Partners.- Hospital Liability for Acts of Physicians.- 3 Standards and Practice Guidelines.- American College of Radiology Standards.- Departmental Standards.- Legal Effect of Standards and Practice Guidelines.- State Legislation.- 4 Anatomy of a Malpractice Lawsuit.- Prefiling Procedures.- Formal Filing.- Discovery.- Deposition.- Settlement Attempts.- Pretrial Conference.- Summary Judgment.- Trial.- Appeal.- 5 Expert Witnesses.- Availability.- Role.- Limitations.- Qualifications.- Consequences of Disqualification to the Witness.- Proper Behavior of an Expert Witness.- “Reasonable Degree of Medical Certainty” Standard.- Practical Tips for the Radiology Expert Witness.- Ethical Considerations.- Adverse Consequences of Being an Expert Witness.- Protecting the Radiologist from Being Falsely Accused by an Expert Witness.- 6 Countersuits.- Possible Causes of Action.- What Should a Radiologist Do If Subjected to an Unjustified Suit?.- 7 Alternative Dispute Resolution.- Limitations of Formal Adjudication.- Mediation.- Arbitration.- Alternative Dispute Resolution in Medical Malpractice.- 8 Criminal Prosecution.- 9 Professional Liability Insurance.- Insurance Contracts.- Occurrence Versus Claims-Made Policies.- Tail and Nose Policies.- Mandatory Insurance Requirements.- Amount of Insurance Coverage.- The Deep Pocket.- Defense of Malpractice Claims.- Settlement of Lawsuits.- 10 Special Residency Issues.- Insurance.- Special Liability Status.- 11 Reactions of Physicians Sued for Malpractice.- Supporting a Sued Radiologist.- 12 Role of the Radiologist-Defendant at Trial.- 13 Risk Management.- Communication with Patients.- II The Missed Diagnosis: Overview.- 14 The Missed Diagnosis: Overview.- Frequency of Errors.- Causes of Errors.- Admitting Errors.- Reporting the “Missed” Diagnosis.- Defending the “Missed” Radiographic Diagnosis.- 15 Interpreting Too Many Studies Per Day.- III Communication and Records.- 16 Radiology Reports.- Comparison with Previous Examinations and Reports.- Significant Discrepancy Between the Final and Emergency/Preliminary Reports.- Signing the Radiology Report.- Correction/Alteration of the Radiology Report.- 17 Communication of the Radiologic Findings.- Failure to Issue a Report.- Delay in Issuing a Report.- Direct Communication.- 18 Release and Storage of Radiologic Images.- Ownership of Images.- Patient Access to Images.- Confidentiality.- Retention of Images.- Storage and Destruction of Images.- 19 Medical Records.- Importance of Proper Medical Records.- Correction/Alteration of the Medical Record.- Adverse Consequences of Improper Alteration of Medical Record.- Inappropriate Entries.- 20 Confidentiality.- HIV-Positive Patients.- IV Radiology Practice and Specific Procedures.- 21 Consent.- Types of Consent.- Informed Consent.- 22 Do Not Resuscitate (DNR) Orders.- Compliance with DNR Orders.- Recommended Approach.- Consequences of Failure to Comply with a DNR Order.- 23 Barium Enema.- 24 Breast Imaging.- Risk of Women Developing Breast Cancer.- Mortality Rates.- Accuracy of Mammography.- Effect of Mammography on Lengthening Survival Time and Reducing Death Rates.- Effect of Delayed Diagnosis of Breast Cancer.- Screening Versus Diagnostic Mammograms.- Mammographic Errors.- Reporting the Mammographic Study.- False-Negative Core Biopsy of the Breast.- Specimen Radiography.- Tracking Patients with Negative Biopsies.- 25 Interventional Procedures.- Technical Issues.- Postprocedure Care.- 26 Ionic Versus Nonionic Contrast Material.- 27 Sedation and Analgesia.- Pediatric Patients.- Adult Magnetic Resonance Imaging.- Interventional Procedures.- 28 Medical Devices.- Off-Label Use.- Informed Consent for Off-Label Use.- Reprocessing and Reuse of Single-Use Devices.- 29 The Pregnant Patient.- Effect of Radiation Exposure on the Fetus.- Determining Whether a Woman Is Pregnant.- Examining the Pregnant Patient.- Radionuclide Imaging.- 30 Computed Tomography Screening Studies.- General Criteria for Effective Screening.- Radiation Risk.- CT Screening for Lung Cancer.- CT Screening for Coronary Artery Disease.- CT Screening for Abdominal Pathology.- Use of Contrast Material in Screening CT Studies.- Medical-Legal Implications.- V Electronic Imaging.- 31 Teleradiology.- Establishment of Physician-Patient Relationship.- Medical Licensing and Insurance.- Jurisdiction for Malpractice Suits.- Other Medical-Legal Aspects.- Relationship Between Local and Distant Radiologists.- 32 E-Mail.- Other Potential Problems with E-Mail.- 33 Picture Archiving and Communications Systems (PACS).- Failure to Interpret “Lost” PACS Images.- VI Governmental/Regulatory.- 34 Credentialing and Peer Review.- Due Process.- Peer Review.- 35 Infected or Substance-Abuse-Impaired Radiologist.- Liability of the Infected/Impaired Radiologist.- Liability of Other Parties.- Informed Consent.- 36 Federal Fraud and Abuse Enforcement and Compliance Plans.- Fraud and Abuse.- Compliance Plans.- Documentation.- 37 Professional Courtesy.- 38 Sexual Harassment.- Sexual Harassment Policy.- Allegations of Sexual Harassment.- What to Do If One Is a Victim of Sexual Harassment.- Employer Course of Action.- 39 Employee Retirement Income Security Act (ERISA).- Impact on Radiologists.

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