Radiology Malpractice in New York: Misinterpreted X-Rays, CT Scans, and MRIs

The Role of the Radiologist in Diagnosis

Radiologists are physicians who specialize in interpreting medical imaging studies. They play a critical role in diagnosis, because they are often the first to identify abnormalities on imaging studies. Their interpretations guide the referring physician diagnosis and treatment decisions.

The radiologist responsibilities include:

• Interpreting imaging studies: The radiologist examines the images and identifies abnormalities (tumors, fractures, bleeding, infections, etc.).
• Generating a report: The radiologist writes a report describing the findings and providing a differential diagnosis (list of possible causes).
• Communicating critical findings: The radiologist must promptly communicate critical or urgent findings to the referring physician. [Link to: /radiology-errors/communication-failures]
• Recommending follow-up: The radiologist may recommend additional imaging, biopsy, or other follow-up for suspicious or indeterminate findings.
• Comparing with prior studies: The radiologist should compare current imaging with prior studies to identify changes over time.

Common Radiology Errors

Radiology errors can occur in several ways:

• Misinterpretation: The radiologist misreads the imaging study -- either missing an abnormality (false negative) or identifying an abnormality that is not present (false positive).
• Perception errors: The radiologist does not see the abnormality, even though it is visible on the images. This can be caused by fatigue, distractions, or inexperience.
• Cognitive errors: The radiologist sees the abnormality but misinterprets it -- for example, attributing a tumor to a benign condition (satisfaction of search).
• Communication failures: The radiologist identifies an abnormality but fails to communicate it to the referring physician, or the communication is delayed. [Link to: /radiology-errors/communication-failures]
• Failure to compare with prior studies: The radiologist does not compare the current imaging with prior studies, missing subtle changes.
• Inadequate imaging technique: The imaging study was not performed correctly (e.g., inadequate contrast, wrong protocol), making interpretation difficult or impossible.
• Failure to recommend follow-up: The radiologist identifies an indeterminate finding but does not recommend appropriate follow-up imaging or biopsy.
• Failure to use appropriate modality: The wrong imaging modality was used (e.g., x-ray instead of CT for suspected fracture).

Misinterpreted X-Rays

X-rays are the most common imaging study, but they can be misinterpreted:

• Missed fractures: Subtle fractures, particularly hairline fractures, stress fractures, and fractures in complex areas (wrist, ankle, spine), can be missed on x-ray. [Link to: /radiology-errors/x-ray-malpractice]
• Missed lung nodules: Small lung nodules, which can be early lung cancer, can be missed on chest x-ray. [Link to: /misdiagnosis/lung-cancer-misdiagnosis]
• Missed pneumothorax: A collapsed lung can be missed, particularly if it is small.
• Missed bowel obstruction: Signs of bowel obstruction can be subtle on abdominal x-ray.
• Missed dislocations: Joint dislocations, particularly in the shoulder and fingers, can be missed.
• Inadequate views: If the x-ray technician does not obtain the appropriate views, the radiologist may not be able to identify the abnormality.

Misinterpreted CT Scans

CT scans provide detailed cross-sectional images and are used to diagnose a wide range of conditions:

• Missed strokes: Early ischemic strokes can be subtle on CT. The standard of care may require a CT angiogram or CT perfusion study to detect the stroke. [Link to: /medical-malpractice/stroke-misdiagnosis] [Link to: /radiology-errors/ct-scan-negligence]
• Missed intracranial hemorrhage: Bleeding in the brain can be missed, particularly if it is small or in an unusual location.
• Missed tumors: Tumors in the brain, lungs, abdomen, and pelvis can be missed on CT.
• Missed aortic dissection: Aortic dissection is a life-threatening condition that can be missed on CT if the radiologist does not look for it or if the imaging technique is inadequate.
• Missed pulmonary embolism: Blood clots in the lungs can be missed on CT angiography. [Link to: /misdiagnosis/pulmonary-embolism-misdiagnosis]
• Missed appendicitis: An inflamed appendix can be missed on CT. [Link to: /misdiagnosis/appendicitis-misdiagnosis]
• Missed bowel perforation: Free air in the abdomen (a sign of bowel perforation) can be missed.
• Inadequate contrast: If the contrast is not administered correctly, the study may be non-diagnostic.

Misinterpreted MRIs

MRIs provide detailed images of soft tissues and are used to diagnose conditions of the brain, spine, joints, and soft tissues:

• Missed brain tumors: Brain tumors can be missed, particularly if they are small or if the MRI protocol is inadequate. [Link to: /radiology-errors/mri-malpractice]
• Missed spinal cord compression: Spinal cord compression (from disc herniation, tumor, or abscess) can be missed, with devastating consequences. [Link to: /spinal-cord-injury/lawyer] [Link to: /spinal-cord-injury/spinal-abscess]
• Missed cauda equina syndrome: Cauda equina syndrome (compression of the nerve roots at the base of the spinal cord) is a surgical emergency that can be missed on MRI. [Link to: /spinal-cord-injury/cauda-equina-syndrome]
• Missed ligament or tendon tears: Tears in the knee, shoulder, and other joints can be missed.
• Missed infections: Infections in the brain (encephalitis), spine (discitis, osteomyelitis), and soft tissues can be missed.
• Missed strokes: Diffusion-weighted MRI is the most sensitive test for acute ischemic stroke, but strokes can still be missed if the radiologist does not look for them or if the protocol is inadequate.
• Inadequate protocol: The MRI protocol must be tailored to the clinical question. If the wrong protocol is used, the study may be non-diagnostic.

Misinterpreted Mammograms

Mammograms are the primary screening tool for breast cancer, but they can be misinterpreted:

• Missed breast cancer: Breast cancer can be missed on mammogram, particularly in women with dense breast tissue. [Link to: /radiology-errors/mammogram-malpractice] [Link to: /misdiagnosis/breast-cancer-misdiagnosis]
• Failure to compare with prior mammograms: The radiologist should compare the current mammogram with prior studies to identify subtle changes.
• Failure to recommend additional imaging: If the mammogram is indeterminate, the radiologist should recommend additional imaging (ultrasound, MRI) or biopsy.
• Inadequate views: If the mammogram technician does not obtain the appropriate views, the radiologist may not be able to identify the abnormality.
• BI-RADS misclassification: The radiologist may misclassify the finding using the BI-RADS system, leading to inappropriate follow-up.

Misinterpreted Ultrasounds

Ultrasounds are used for a variety of purposes, including obstetric, abdominal, and vascular imaging:

• Missed fetal anomalies: Fetal anomalies can be missed on obstetric ultrasound, with significant implications for the family.
• Missed ectopic pregnancy: Ectopic pregnancy (a pregnancy outside the uterus) is a life-threatening condition that can be missed on ultrasound.
• Missed appendicitis: Appendicitis can be missed on ultrasound, particularly in children.
• Missed deep vein thrombosis (DVT): Blood clots in the legs can be missed on ultrasound. [Link to: /misdiagnosis/pulmonary-embolism-misdiagnosis]
• Missed gallstones: Gallstones can be missed on ultrasound. [Link to: /surgical-errors/gallbladder-surgery-malpractice]
• Missed abdominal aortic aneurysm: An enlarged aorta can be missed on ultrasound.
• Operator dependence: Ultrasound is highly operator-dependent, and the quality of the study depends on the skill of the technician. [Link to: /radiology-errors/ultrasound-malpractice]

Communication Failures in Radiology

Communication failures are a significant cause of radiology malpractice. The standard of care requires the radiologist to promptly communicate critical or urgent findings to the referring physician. [Link to: /radiology-errors/communication-failures]

Critical findings that require prompt communication include:

• Suspected stroke or intracranial hemorrhage
• Suspected aortic dissection or rupture
• Suspected pulmonary embolism
• Suspected bowel perforation or obstruction
• Suspected appendicitis
• Suspected spinal cord compression or cauda equina syndrome [Link to: /spinal-cord-injury/cauda-equina-syndrome]
• Suspected cancer (new or worsening)
• Suspected fracture (particularly spinal or hip)
• Suspected ectopic pregnancy
• Any finding that requires urgent or emergent treatment

When Radiology Errors Constitute Malpractice

Not every missed finding on an imaging study is malpractice. Radiology is not an exact science, and some findings are genuinely difficult to see, particularly if they are small, subtle, or in an unusual location. Malpractice requires a deviation from the standard of care that caused harm.

Radiology errors constitute malpractice when:

• The radiologist missed a finding that should have been identified by a reasonably competent radiologist.
• The radiologist misinterpreted a finding that should have been correctly interpreted.
• The radiologist failed to compare the current imaging with prior studies.
• The radiologist failed to communicate critical or urgent findings to the referring physician. [Link to: /radiology-errors/communication-failures]
• The radiologist failed to recommend appropriate follow-up for suspicious or indeterminate findings.
• The imaging study was not performed correctly (inadequate technique, wrong protocol), making interpretation difficult or impossible.
• The wrong imaging modality was used.
• The deviation caused harm (the condition progressed, the patient suffered permanent injury, or the patient died).

Proving Your Radiology Malpractice Case

To prove a radiology malpractice case, you need:

• Medical records: Including the radiologist report, the referring physician notes, and all other medical records. [Link to: /resources/how-to-get-medical-records-for-a-lawsuit]
• The imaging studies: The actual images (not just the report), which can be independently reviewed by an expert radiologist.
• Expert review: Independent review by board-certified radiologists who can compare the images with the radiologist report and determine whether the standard of care was met.
• Standard of care evidence: Establishing what the standard of care requires for the imaging study in question.
• Causation evidence: Establishing that the radiology error caused harm -- for example, that a missed tumor on a CT scan caused the cancer to progress to a more advanced stage. [Link to: /delayed-diagnosis-lawyer/loss-of-chance]
• Expert testimony: From qualified experts.

New York Statute of Limitations

Radiology malpractice claims are subject to the 2.5-year statute of limitations for medical malpractice (CPLR 214-a), running from the date of the negligent act.

Key considerations:

• Date of the negligent act: The 2.5-year clock starts on the date of the radiologist interpretation (the date of the radiology report).
• Continuous treatment doctrine: If you continued to receive treatment from the same provider for the same condition, the statute may be extended.
• Lavern's Law (cancer): If the radiology error involved cancer (e.g., a missed tumor on a mammogram), Lavern's Law provides 2.5 years from the date of discovery, with a 7-year outer limit. [Link to: /misdiagnosis/laverns-law]
• Municipal hospitals: If the imaging study was performed at a municipal hospital (NYC Health + Hospitals), a notice of claim must be filed within 90 days. [Link to: /hospital-negligence/suing-nyc-h-h]
• Wrongful death: If the radiology error caused death, the wrongful death claim must be filed within 2 years. [Link to: /wrongful-death-lawyer]

Common Defense Arguments and How We Counter Them

Defense: The finding was subtle and difficult to see.

Defense attorneys use several arguments in radiology malpractice cases:

• Our Counter: While some findings are genuinely subtle, the standard of care requires the radiologist to identify findings that a reasonably competent radiologist would identify. We use expert testimony from board-certified radiologists who independently review the images to determine whether the finding should have been identified.

Defense: The imaging study was technically suboptimal.

Our Counter: If the imaging study was technically suboptimal (e.g., inadequate contrast, wrong protocol), the radiologist should have noted this in the report and recommended repeat imaging. If the radiologist failed to do so, the standard of care was breached.

Defense: The referring physician should have followed up on the findings.

Our Counter: The radiologist has an independent duty to communicate critical or urgent findings to the referring physician. If the radiologist failed to communicate the findings, the radiologist is liable, regardless of the referring physician actions. [Link to: /radiology-errors/communication-failures]

Defense: Earlier diagnosis would not have changed the outcome.

Our Counter: We use expert testimony to establish that earlier diagnosis would have changed the outcome -- for example, that a cancer caught at an earlier stage would have been more treatable. [Link to: /delayed-diagnosis-lawyer/loss-of-chance]

Compensation Available

A successful radiology malpractice claim in New York can provide compensation for:

• Medical expenses: Including past and future medical care, surgeries, rehabilitation, medications, and assistive devices
• Lost wages and lost earning capacity: For time missed from work and reduced ability to work
• Pain and suffering: NY has no cap on non-economic damages
• Permanent disability: For brain damage, paralysis, organ damage, and other permanent conditions
• Future medical care costs: Based on a life care plan, discounted to present value
• Loss of consortium: For the impact on family relationships
• Wrongful death damages: If the radiology error caused death [Link to: /wrongful-death-lawyer]

What to Expect Working with MDLaw Firm

When you contact MDLaw Firm about a potential radiology malpractice case:

• Free Consultation: We listen to your story and review the basic facts.
• Immediate Deadline Assessment: We evaluate the 2.5-year statute of limitations, Lavern's Law (for cancer cases), and any municipal notice of claim deadlines.
• Record Retrieval: We obtain all medical records, radiologist reports, and the actual imaging studies (not just the reports). [Link to: /resources/how-to-get-medical-records-for-a-lawsuit]
• Expert Review: We engage board-certified radiologists to independently review the images and the radiologist reports.
• Causation Analysis: We establish that the radiology error caused harm.
• Life Care Plan: If the injury is permanent, we engage a life care planner to project future care needs.
• Litigation: We file within the statute of limitations and handle all aspects of discovery and trial.
• Resolution: We pursue maximum compensation through settlement or verdict.

Frequently Asked Questions

The value of a medical malpractice case in New York depends on several factors, including the severity of the injury, the strength of liability evidence, and the economic and non-economic damages involved. New York is one of the few states with no caps on medical malpractice damages, meaning there is no artificial limit on what you can recover. Below are typical settlement ranges based on injury severity.