Characteristics of Radiologists Serving as Medical Malpractice Expert Witnesses for Defense Versus Plaintiff.

PURPOSE: Previous studies have reported higher qualification characteristics for anesthesiologists, neurosurgeons, orthopedic surgeons, and otolaryngologists serving as defense (versus plaintiff) medical malpractice expert witnesses. We assessed such characteristics for radiologist expert witnesses. METHODS: Using the Westlaw legal research database, we identified radiologists serving as experts in all indexed medical malpractice cases between 2010 and 2019. Online databases were used to identify years of practice experience and scholarly bibliometrics. Using Medicare claims, individual radiologist practice types and mixes were ascertained. Radiologists testifying at least once each for defense and plaintiff were excluded from our defense-only versus plaintiff-only comparative analysis. RESULTS: Initial Boolean searches yielded 1,042 potential cases; subsequent manual review identified 179 radiologists testifying in 231 lawsuits: 143 testified in one case (58 defense, 85 plaintiff) and 36 testified in multiple cases (10 defense-only, 14 plaintiff-only, 12 both). The 68 defense-only experts had fewer years of practice experience than the 99 plaintiff-only experts (28.3 versus 31.8 years, P = .02), but the two groups were otherwise similar in both practice type (44.6% versus 54.9% academic, P = .62) and mix (63.8% versus 65.8% practiced as subspecialists, P = .37) and as well as numbers of publications (60.5 versus 62.8, P = .86), citations (1,994.1 versus 2,309.2, P = .56), and h-indices (17.2 versus 16.8, P = .89). CONCLUSIONS: In contrast to other specialists, radiologists serving as medical malpractice expert witnesses for defense and plaintiff display similar qualifications across various characteristics. Published practice parameter guidelines and experts' ability to blindly review archived original images might together explain this interspecialty discordance.

Relative Prevalence and Characteristics of Malpractice Litigation Involving Radiology Trainees.

PURPOSE: To assess the prevalence and characteristics of medical malpractice litigation involving radiology trainees. METHODS: Using a LexisNexis legal database keyword search, we identified all state and federal lawsuits between 2009 and 2018 yielding formal appellate and lower court opinions (precedent setting "complex litigation") potentially involving physician trainees. Available judicial records were systematically reviewed to identify malpractice matters with material trainee involvement. Cases were categorized by criteria including specialty and location. Incidence rates were calculated for all specialties. Radiology lawsuits were characterized further. RESULTS: Initial LexisNexis Boolean database search yielded 8,935 potentially relevant cases with 580 confirmed as malpractice materially involving physician trainees. Annual cases trended downward (high 70, low 37). Most originated in New York (195 of 580; 33.6%), Ohio (41; 7.1%), and Pennsylvania (34; 5.9%) and involved surgery (204; 35.2%), obstetrics and gynecology (114; 19.7%), and medicine (105; 18.1%). The case incidence rate for all trainees was 0.63 per 1,000 trainee years. Of 309 cases with known outcomes, defendant physicians prevailed in 238 (77.0%). Radiology trainees represented only 23 cases (4.0%), corresponding to an incidence rate ratio of 0.79 (confidence interval 0.52-1.20). Radiology litigation most frequently involved alleged missed diagnoses (14 of 23; 60.8%) and procedural complications (7; 30.4%). Defendant radiologists prevailed in 9 of the 13 cases with known outcomes (69.2%). CONCLUSION: Complex medical malpractice litigation involving physician trainees is infrequent and decreasing over time. Lawsuits involving radiology trainees are uncommon, less likely than for many nonradiology trainees, and typically involve alleged missed diagnoses or procedural complications. Defendant radiologists usually prevail.

Distribution and Characteristics of Malpractice and Nonmalpractice Litigation Involving Interventional Radiologists in the United States from 1983-2018.

PURPOSE: To describe the distribution and characteristics of both malpractice and nonmalpractice litigation involving interventional radiologists (IRs). METHODS: Using Westlaw and LexisNexis court legal databases, we identified all United States federal and state cases between 1983 and 2018 yielding appellate court or judicial opinions (legally precedent setting "complex litigation") potentially involving IRs. Relevant court documents were individually and systematically reviewed to confirm IR involvement. Cases were categorized by type, jurisdiction, time, and disposition. RESULTS: Initial Boolean searches resulted in 251 and 575 potentially relevant Westlaw and LexisNexis cases, respectively. After eliminating duplicative (eg, multiple appeals) matters from the 123 cases individually confirmed meeting inclusion criteria, 85 unique cases were identified. Of these, 51 (60.0%) involved malpractice allegations, of which vascular interventions were most common (23/51; 45.1%). Of 34 (40.0%) nonmalpractice cases, employment (21/34; 61.8%) and disability (4/34; 11.8%) disputes dominated. Involved IRs prevailed in 56.9% (29/51) of malpractice and 11.8% (4/34) of nonmalpractice cases. In state courts, the Northeast accounted for 35.7% (20/56) of all litigation and 43.2% (19/44) of all malpractice litigation. Nationally, complex litigation has increased over time, from a low of zero cases in 1983 to a high of 11 in 2013. CONCLUSION: Litigation involving IRs typically surrounds not only malpractice matters, but also employment and disability disputes. With only 85 unique cases over 35 years, complex litigation is uncommon but increasing. IRs seeking to minimize litigation should not neglect the risks associated with employment contracting and disability insurance.