Perspectives on Neuroradiology Medical Expert Testimony: Fact and Fiction

Characteristics of Radiologists Serving as Medical Malpractice Expert Witnesses for Defense Versus Plaintiff

PURPOSE

Previous studies have reported higher qualification characteristics for anesthesiologists, neurosurgeons, orthopedic surgeons, and otolaryngologists serving as defense (versus plaintiff) medical malpractice expert witnesses. We assessed such characteristics for radiologist expert witnesses.

METHODS

Using the Westlaw legal research database, we identified radiologists serving as experts in all indexed medical malpractice cases between 2010 and 2019. Online databases were used to identify years of practice experience and scholarly bibliometrics. Using Medicare claims, individual radiologist practice types and mixes were ascertained. Radiologists testifying at least once each for defense and plaintiff were excluded from our defense-only versus plaintiff-only comparative analysis.

RESULTS

Initial Boolean searches yielded 1,042 potential cases; subsequent manual review identified 179 radiologists testifying in 231 lawsuits: 143 testified in one case (58 defense, 85 plaintiff) and 36 testified in multiple cases (10 defense-only, 14 plaintiff-only, 12 both). The 68 defense-only experts had fewer years of practice experience than the 99 plaintiff-only experts (28.3 versus 31.8 years, P = .02), but the two groups were otherwise similar in both practice type (44.6% versus 54.9% academic, P = .62) and mix (63.8% versus 65.8% practiced as subspecialists, P = .37) and as well as numbers of publications (60.5 versus 62.8, P = .86), citations (1,994.1 versus 2,309.2, P = .56), and h-indices (17.2 versus 16.8, P = .89).

CONCLUSIONS

In contrast to other specialists, radiologists serving as medical malpractice expert witnesses for defense and plaintiff display similar qualifications across various characteristics. Published practice parameter guidelines and experts' ability to blindly review archived original images might together explain this interspecialty discordance.

The Role of the Expert Witness in Radiology: Challenges and Strategies for Overcoming Them

Expert witnesses provide an important service in malpractice cases in the United States because they educate the jury on the standards of care relevant to a particular case. In cases in which the defendant physician is a radiologist, the decision often rests on whether a retrospectively detected abnormality should have been perceived and reported, an "error of omission." Errors of omission are usually termed "perceptual" in the literature and are the most common cause of malpractice suits in radiology. Allegations often hinge on whether these errors represent a breach of duty by the defendant radiologist and whether they resulted in an injury to the plaintiff or patient. In short, jurors are asked to decide if the radiologist performed below the "standard of care," generally defined as that which a minimally competent, reasonable, or ordinary physician in the same field would do under similar circumstances. The authors describe challenges associated with being an expert witness and provide guidance to radiologists on how to address cases involving alleged perceptual errors.