Radiologists played a role in 15% of diagnosis-related claims, 80% of which involved the misinterpretation of clinical tests, according to the August 2018 issue of the Red Signal Report, published by Coverys, a medical professional liability insurer. The report provides analysis of 10,692 claims made that closed between 2013 and 2017, of which 595 claims named a radiologist. For claims that named a radiologist, the report says significant patient harm often occurred, and such claims also frequently allege an incorrect or delayed diagnosis. Claims that allege diagnostic failure by a radiologist involve cancer diagnoses more than any other condition, with breast, lung, pancreatic, and ovarian cancer being the most frequently involved. The claims often say that radiologists failed to follow up with patients on abnormal test results. Claims that allege diagnostic failure by a radiologist are associated with high-severity patient injury, including death and permanent grave or significant injuries. Among diagnoses-related claims, only claims involving general practitioners were more common than those involving radiologists, involved in more than 20% of diagnosis-related claims. The report includes recommendations for managing risk in radiology, such as using decision-support tools, standard treatment protocols, and checklists to manage workflow and decrease reliance on memory. It also suggests that radiologists use clear language when speaking to patients, avoiding phrases that can be misinterpreted such as the terms "cannot rule out," "consistent with," or "likely represents."

HRC Recommends: Physicians may need to recognize diagnostic uncertainty and seek assistance—from colleagues, reference materials, or clinical decision support tools, for example. By collecting and analyzing reported errors in diagnosis, and analyzing claims and litigation involving diagnostic errors, risk managers can help physicians better understand where in the diagnostic process the failures occur; better understand the work system factors that contribute to their occurrence; and determine how such failures may be prevented or mitigated. Patient harm resulting from diagnostic error—notably delayed diagnosis—often involves communication gaps and failure to accurately communicate findings, as reported in the claims study.