Radiology: Probing legalities of ultrasound

Dec 11 2012, 16:23 IST
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Although all fields of medicine attract medico-legal attention, recently, the field of diagnostic sonography has been in the public-eye. Although all fields of medicine attract medico-legal attention, recently, the field of diagnostic sonography has been in the public-eye.
SummaryM Neelam Kachhap examines the field of diagnostic ultrasonography, ethical issues connected to this subject and the legal premise under which it is supposed to be practised

particular circumstances of each case is what the law requires.”

Legalities in


Other than negligence there are other legalities in ultrasonography such as missed diagnosis, invented lesions, and misreported lesions. "Missed diagnosis in ultrasonography is a disease/lesion which could not be interpreted properly, and reported appropriately by the sonographer, in spite

of it being there and is

obvious when another sonographer does the ultrasound scan with reasonable skill and care within reasonable time from the first scan," informs Dr Unni.

"Radiologic errors are of two types: cognitive, in which an abnormality is seen but its nature is misinterpreted, and perceptual or the ‘miss’, in which a radiologic abnormality is simply not seen by the radiologist on initial interpretation. The perceptual variety accounts for approximately 80 per cent of all radiologic errors. Because radiologic errors are common, and allegations that a diagnostic error has been committed account for 70 per cent of all medical malpractice lawsuits filed against radiologists, it is no wonder that radiologists are being forced into the courtroom as defendants in malpractice actions with disconcertingly high frequency," elaborates Dr Chudgar.

"The Supreme Court of India, in Jacob Mathew v. State of Punjab (2005) 6 SCC 1, held that, “A professional may be held liable for negligence on one of the two findings: either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did possess. The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession. It is not possible for every professional to possess the highest level of expertise or skills in that branch which he practices. A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the

performance of the professional proceeded against on indictment of negligence. “Accordingly, we believe that ‘missed diagnosis’ could be equivalent to

‘medical negligence’ in the eyes of law if the

test described above is proven. Examples of missed diagnosis are instances when an ultrasonologist fails to report an anomaly e.g. a twin pregnancy which is then subsequently picked by a second ultrasonography done by himself or

by a peer or something

that goes unnoticed and leads to a complicated

clinical outcome. In

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