The radiology fellow and the avoidable lawsuit (Coverys)
Patricia Buckley was a retired teacher who lived most of her life in the midwest, but had recently moved to Dayton, Ohio.
She shared a small 1-bedroom apartment with her trusted companion of many years - a parrot named Mr. Gatsby.
Most nights she would watch movies, but occasionally she enjoyed hosting small dinner parties. One morning, as Patricia was cleaning her house, she suddenly felt tired and dizzy, and as the day progressed, she felt more achy and developed a slight cough.
“I hope I’m not getting sick right before my trip to Europe,” she thought aloud, as she picked up the phone to make an appointment with her primary care physician.
The next day, Patricia arrived for her appointment with her primary physician, Dr. Larson.
The conversation was relaxed. Patricia said she was mostly worried about the fatigue.
She explained, “I’m going to visit my daughter and my lovely grandson in Europe for the summer, and I'm pretty sure I won't be able to keep up with him or help around the house if I’m exhausted like this.” Dr.
Larson explained that she thought it was most likely a viral infection, but that she needed to get some blood tests and a chest X-ray just in case Patricia had developed a walking pneumonia or something called parrot fever - both of which could be treated with antibiotics.
Patricia felt reassured and headed out to get the lab work and chest X-ray done. A few hours later, an overnight radiology fellow, Dr.
Samir Patel, was reading the chest X-ray of patient 7322881. He didn’t know Patricia - he just knew her medical record number.
The reason for the chest X-ray? Two words “rule-out pneumonia”.
“Could this be a tumor? Or tuberculosis?”, he wondered as dictated the report.
“Findings: No evidence of pneumonia. 1-centimeter oval lesion in the left upper lobe.
No hilar adenopathy...“ he finished up. He clicked over to review the next case.
A few hours later he called it a night. The next morning Dr.
Patel reviewed the radiographs from the previous night with his attending. The attending agreed - there wasn’t any evidence of pneumonia, but that oval shape was unusual and definitely needed following up on.
Dr. Patel wrote down the patient’s phone number on a pad of paper.
Dr. Patel batched all of his follow up calls and did them each Friday.
That Friday, when he called Patricia nobody answered and he left a voicemail. A week later he called again, and left another voicemail.
Two weeks later the voicemail inbox was full and wasn’t accepting any more messages. Dr.
Patel struck the number off his list - by that point, he could barely remember what the call was even about. What Dr.
Patel didn’t know was that Patricia was in Switzerland and wasn’t getting her voicemails. Near the end of the summer, Patricia’s health rapidly declined so she flew back to the US to stay with extended family.
A few weeks later, Patricia passed away due to metastatic lung cancer. One afternoon, Dr.
Patel received a letter stating that his hospital was being sued and that he was named in the lawsuit because he had done the initial dictation on the chest X-ray.
Now - to rewind this back - let’s imagine that Dr. Patel or someone on his team had gotten in contact with Patricia’s primary physician, Dr.
Larson. Dr.
Larson had a more established relationship with Patricia and may been able to contact her while she was in Europe. It’s possible that Patricia could have had further studies done to work up this lung nodule - perhaps a CT or
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