One of the things I see over and over as a Houston, Texas, medical malpractice attorney is how important information can fall through the cracks in medicine.
For instance, a man went to see a urologist because he was having pain between his ribs and hips (the flank area). The doctor thought it was likely a kidney stone but ordered an abdominal CT scan just to be sure.
A radiologist interpreted the CT scan and, sure enough, found the kidney stone. He also wrote in his report that there was a ““soft tissue mass suspicious for colonic neoplasm” and recommended a colonoscopy to check it out.
Doctors call this an incidental finding. It’s something that the radiologist saw on the CT scan, but it wasn’t something he was looking for.
When a radiologist finds anything that’s so concerning that it requires follow-up, it’s called a critical finding. When there’s a critical finding, the standard of care requires radiologists to notify the doctor who ordered the study. That’s what the radiologist did here—he called the urologist’s office on a Friday evening and left a voicemail asking him to return the call.
The radiologist also faxed a report to the urologist that described his findings. Page one of the report discussed the kidney stone. At the bottom of the first page, the radiologist started talking about a suspicious soft tissue mass and continued his narrative on the second page.
The urologist only read the first page of the radiology report and did not return the radiologist’s call. He did a procedure called a lithotripsy to fix the kidney stones and never informed the patient that he might have colon cancer.
Sadly, 19 months after having his kidney stone lithotripsy, the patient was diagnosed with Stage IV colon cancer that has metastasized and spread throughout his whole body.
This unfortunate man’s case illustrates some important lessons:
· While the radiologist faxed the report and left a voicemail to the radiologist, he still missed the mark. Medical experts recommend direct communication between the radiologist and the ordering physician when there’s a critical finding.
· The urologist only read one page of a two-page radiology report. As you would expect, the standard of care requires the doctor who orders a radiology study to read the entire report, which contains all of the radiologist’s impressions and conclusions.
· As a patient, you can improve your safety by asking your doctor for a copy of any radiology or lab report when testing is ordered. Read it yourself and then ask questions to follow-up.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2018, by H Texas as one of Houston’s top lawyers. Also, in 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.
