Risk management in radiology.

Recent US nationwide research on malpractice lawsuits shows that the most common cause of medical malpractice suits against radiologists was error in diagnosis (mainly failure to diagnose instead of delay); the category next in frequency was procedural complications, followed by inadequate communication with either patient or referring physician. Risk management is a fundamental instrument to prevent and limit errors and adverse events. This article analyzes risk management in radiology addressing the most common ethical-legal issues on appropriateness of prescriptions, informed consent, and management of adverse events. Effective remedial actions are proposed to avoid malpractice claims that would help physicians in preventing malpractice stress syndrome, leading to defensive medicine.

Fatal self administration of tramadol and propofol: a case report.

We describe a case of unintentional intoxication due to tramadol and propofol self administration, occurred in a middle aged man, healthcare provider, deceased despite advanced medical assistance an hour later the onset of severe and increasing dyspnea. Toxicological analysis performed with gas chromatography-mass spectrometry in blood sample, evidenced a lethal tramadol concentration and therapeutic level of Propofol. Quantitative determination was also performed in other specimens such as bile, tissues (liver, spleen, kidney) and pubic hair, to assess chronic exposure. Toxicological results and autopsy findings, supported by clinical and hematochemical data, suggested a myocardial damage, associated with respiratory failure.

Malpractice in radiology: what should you worry about?

Over recent years the professional role of the radiologist has been evolved due to the increasing involvement in the clinical management of the patient. Radiologists have thus been increasingly charged by new duties and liabilities, exposing them to higher risks of legal claims made against them. Malpractice lawsuits in radiology are commonly related to inappropriate medical care or to the poor physician-patient relationship. In the present paper, we provide overview of the basic principles of the medical malpractice law and the main legal issues and causes of legal actions against diagnostic and interventional radiologists. We also address some issues to help radiologists to reduce risks and consequences of malpractice lawsuits. These include (1) following the standard of care to the best of their ability, (2) cautious use of off-label devices, (3) better communication skills among healthcare workers and with the patient, and (4) ensuring being covered by adequate malpractice insurance. Lastly, we described definitions of some medicolegal terms and concepts that are thought to be useful for radiologists to know.

Case study of sudden cardiac death caused by lypomatous hypertrophy of the interatrial septum.

Lipomatous hypertrophy of the interatrial septum (LHIS) is a benign cardiac mass characterized by fat accumulation in the interatrial septum. It may represent an incidental autopsy finding or may be associated with atrial arrhythmias, obstructive symptoms or sudden death. The case described here is a peculiar case of sudden death secondary to LHIS.