Legal Case: Radiology Technician

Medical Legal Case

Working in the healthcare industry is exciting and rewarding but as with any job there are risks and liability issues. In the field of radiology, it goes beyond just taking images of whats going on in the inside of the body. Radiology Technicians have to be prepared for anything. The day can range from text book non life threatening injuries to thinking outside of the box for trauma injuries and all the while being careful to make sure the decisions you make are the best solutions for the patient. Radiology Technicians live by the ARRT Code of Ethics and Standard of Care. In the following case an older man was referred to a hospital for an air contrast lower gastrointestinal examination both the radiology technician and

technologist failed to provide such care. Section A. Code of Ethics number 4, 5, and 6 were violated and as a result the patient sustained a skull fracture and epidural hematoma.
In the case of the 66 year old patient, after completing the fluoroscopic and spot film portion of the examination the radiologist instructed the radiology technician to obtain radiographs of the patient’s abdomen in the supine, prone, oblique, lateral and anteroposterior view of the abdomen in the upright position. The radiologist left the room and the radiologist technician proceeded to obtain the radiographs.

The technologist asked the patient if he was able to stand for the upright abdomen exam and the patient affirmed that he could. The radiology technician positioned the patient against the wall bucky, and as the technologist walked to the control panel, the patient collapsed and hit his head on the floor. The patient was taken to the operating room, where a neurosurgeon evacuated the hematoma. A malpractice lawsuit against the radiologist, the radiology technologist, and the hospital. The lawsuit alleged that the patient had sustained a “serious head injury with permanent sequelae” (Berlin, par3) because the defendants had failed to provide a standard of care in allowing the patient to stand alone without support of personnel during a radiologic examination that consisted of distending the colon with air and barium to such degree that sudden loss of consciousness should have been anticipated. The radiologist and radiology technician violated Section A, Code of ethics number 4, 5 and 6 which states, “4. the radiologic technologist practices technology founded upon theoretical knowledge and concepts, uses equipment and accessories consistent with the purposes for which they were designed and employs procedures and techniques

appropriately. 5. the radiologic technologist assesses situations; exercises care, discretion and judgment; assumes responsibility for professional decisions; and acts in the best interest of the patient. 6. the radiologic technologist acts as an agent though observation and communication to obtain pertinent information for the physician to aid in the diagnosis and interpretation and diagnosis are outside the scope of practice for the profession.” (ARRT). Had the radiologist assessed the well being of his patient, applied his knowledge of the exam that was being performed and the side effects of the side effects that may or may not occur, a better decision on what type of examinations the patient could tolerate would have avoided a head injury. Had the radiology technician applied their technical knowledge, exercised care, judgement and relayed any concerns to the radiologist the patient may have avoided a head injury.
During discovery proceedings, the radiologist blamed the radiology technician for not providing a standard of care and that is was not his responsibility to provide additional assistance for the procedure.

Instead that it was the duty of the radiology technician to assess the patient and get additional assistance when necessary. A radiology expert witness retained by the plaintiff criticized each of the defendants. “The expert testified in a deposition that the hospital should have provided at least one other person to assist the technologist so that the patient would not have to stand unassisted. The expert also charged that the technologist acted improperly by permitting the patient to stand alone and that the technologist should have requested additional help. The expert criticized the defendant radiologist for not remaining in the room to supervise the technologist until the entire examination had been completed. The expert stated that the radiologist had a duty to appropriately supervise the actions of the technologist and that his failure to do so constituted a breach of the standard of care” (Berlin, par. 4). However, an expert radiologist retained by the defense supported the actions of the defendant radiologist, testifying that the hospital should be the one to determine how many technologists and how much assistance was needed for conducting lower gastrointestinal examinations. The expert for the defense agreed that it was the responsibility of the radiologist to

determine the kind of radiographic exams required, but the radiology technologist was responsible for actually obtaining the radiographs and applying a standard of care. In situations like this Respondent Superior, “meaning let the master answer” (Gurley, Callaway, pg. 145) often comes into play. Radiology technologists are usually employed by a hospital, clinic or private radiology office which would be the ‘master’ of the technologist. Therefore the ‘master’ can be held jointly liable for whatever the radiologic technologist might do in a negligent manner. An injured patient does not have to show proof that the ‘master’ failed to provided a standard of care but that the radiologic technologists was negligent. At the end of the day the defendants decided to settle the lawsuit for $300,000 because they were concerned that the jury might hold the radiologist and radiologist technologist liable for the injuries sustained by the patient. Both the hospital and radiologist paid the amount equally.
The job of a radiologist and radiology technician is very complex. Every patient is unique and the outcome of the radiographic examination can not always be foreseen. However, following a routine, standard of care, and always making sure that you have the best interest of the patient in mind can help avoid situations like what happened in this case with the 66 year old man. Maybe the radiologist relied too heavily on the the radiology technologist to assess such care or maybe the radiology technologist relied too heavily on the expertise of the radiologist. Either way, this was a great case study to educate students going in the radiology field and understanding that their actions can have huge impacts not only to themselves but to the patient, radiologist and the hospital in which they will be employed.