The lawyer alone can’t prove a physician is negligent. It takes another physician.

” then won’t lawyers vilify doctors even more for killing patients with an “unnecessary test”?”

I don’t know. Have they ever before? Considering it would take another physician to opine as to the unnecessary nature of the test at trial, probably not.

A dark room with a computer screen is about the same whether it is 50 yards or 500 miles away.

Think about it this way: small hospitals have a hard time supporting staff. What if you developed a firm of radiologists, all in one building, with HD monitors and a trunk line. You get a “film”, upload it to the firm, and their 24/7 staff send you a result.
They should all be pretty good at what they do, if it is all that they do.

Just a thought.

And look at it from another perspective: In many cases – especially in rural hospitals – it is cost-prohibitive to have a radiologist in-house 24/7. Is it better to have 24 hour access to someone who can read the tests quickly or is it better to wait a day or more for the results to be read by the in-house radiologist?

With all of the cost-cutting measures taking place in medicine right now, teleradiology/telemedicine is going to become more common, not less common.

It is absurd for the plaintiff attorney in this case to be babbling to the media about off-site radiologists as if their location made any difference in the case.

Let’s say that we perform angiography on every patient with abdominal pain so that we catch the small proportion of patients that present within time to save their lives. Because the disease is quite rare to begin with, we’re going to do an awful lot of “unnecessary” testing – right? After all, when the result of a test was negative, the test probably shouldn’t have been performed, right?
Now mesenteric angiograms are not without risks. You can actually cause a clot in the mesentery by injecting the dye. There are allergic reactions to the dye. The dye may cause kidney failure. Infections can develop. The catheter can perforate a blood vessel requiring urgent surgery to fix the problem. So we’re now introducing all of these risks to more than 99.9% of patients to try to save the one person who may present in enough time and who may be stable enough to take to surgery and who will be medically healthy enough to survive the high perioperative mortality rate.

It takes a very astute physician to catch a case of mesenteric ischemia and even in those cases that are caught “promptly,” the outcomes are usually suboptimal.

So if a patient with abdominal pain who doesn’t have mesenteric ischemia gets an angiogram and dies from the testing, then won’t lawyers vilify doctors even more for killing patients with an “unnecessary test”?

My understanding is that good outcomes for mesenteric ischemia are when they are caused by abdominal trauma (e.g., car accident), and are brought into the ER within minutes of the accident, and there is something the surgeon can do to repair circulation. When the problem is the result of a degenerative condition (e.g., arteriosclerosis), there isn’t the obvious justification to cut someone open as soon as they arrive at the ER.

Which doesn’t mean the radiologist is off the hook – we don’t know if he should have seen something on the scan. But from the description we’ve seen of this case, that lady’s fate was probably sealed before she got to the hospital, let alone by the time the radiologist was called.

“The successful outcome is dependent upon a high index of suspicion and prompt management.”

Isn’t that the crux of this case as far as liability goes? Was the management prompt?

The mortality rate might go to damages, but do you think it bears on whether the treatment or lack thereof was negligent?