Caroselli, Beachler & Coleman, L.L.C.

Failure to communicate leads to tragic failure to diagnose

A failure to diagnose can often lead to irreversible injury. A Pennsylvania woman arrived at an emergency room with a severe headache. The doctor suspected a hemorrhage but ordered a computed tomography (CT) to verify his suspicion. Based upon a digital version of the CT, the out-of-town radiologist instead ruled it to be a brain tumor that was not immediately life threatening. The woman was released.

Several hours later, the woman then called an ambulance because she was suffering from severe pain. A more sophisticated CT was ordered which, upon examination by a radiologist in Hong Kong, revealed an additional mass - an abscess. The emergency room doctor never spoke to this radiologist and misinterpreted or failed to understand the radiology report. The patient was again released.

This woman was later found by her parents at home lying on the floor with a ruptured abscess. The woman spent 11-weeks in a coma and suffered severe brain damage.

Lack of communication between emergency doctors and radiologists can often lead to a tragic misdiagnosis. Physicians and radiologists used to work together at the same facility and could discuss x-rays and scans together before deciding what to do next. Now the radiologist may be on the other side of the world and never even speak to the emergency doctor in person.

Though e-mails and faxes can now allow treating doctors to communicate across the world with any number of specialists, this can also lead to confusion and errors. Reliance upon a report may not be enough for a treating doctor to access a course of treatment. On the other hand, a radiologist may not be aware of the circumstances as to why he is asked to interpret a particular scan to begin with.

However, with the consequences that can result from such a mistake, such confusion or error cannot be tolerated. Medical providers at all levels need to understand the consequences of their actions.

Source: msnbc.com, "Is a doctor reading your X-rays? Maybe not," by Katherine Eban, Oct. 26, 2011

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