Use of Expert Testimony Questioned in Malpractice (LiveScience.com)

A new study calls to the stand the legitimacy of expert
witnesses, those doctors and other medical specialists hired by lawyers in
medical malpractice suits to convince the jury that someone somewhere goofed.

The study, published in the August issue of the American
Journal of Roentgenology, implies that you get what you pay for – which is a
good thing for malpractice lawyers, who can hire those experts who deliver the
“right” answer or who benefit from hindsight in their medical
interpretations.

For this study, a team of researchers led by Richard
Semelka, a professor of radiology in the School of Medicine at the University
of North Carolina at Chapel Hill, sent six CT scans (of various parts of the
body) to 31 radiologists. Five of the CT scans captured a range of injuries
seen in an emergency room, and one CT scan of the spine was from a lawsuit.
The radiologists were blinded to which scan was which, and they were asked to
interpret them as they would in an emergency room under normal working
circumstances.

Interpreting a CT scan
can be a subjective art; yet between 30 and 31 of the total 31 radiologists
subjectively came to the same, independent conclusion that was different from
the paid expert witnesses in that legal case – an interpretation of the scan
that was indeed similar to what the sued radiologist had concluded.

Fractured judgment

What was striking was the uniformity among radiologists,
with a range of professional experience and workplace settings. One of the CT
scans showed three obvious medical problems, as a baseline test of expertise,
and all the radiologists identified them correctly. Another CT scan matched the
scan in the lawsuit – fractures and soft tissue damage from a car
accident – and 30 of 31 radiologists got this right.

Three other CT scans were random – new scans pulled from
Semelka’s institution to simulate a real-life emergency room caseload. Again,
the radiologists were mostly in agreement.

And now we turn to exhibit A, the CT scan in the medical
malpractice suit, which ultimately was settled out of court for an undisclosed
sum. None – that is, 0 out of the 31 radiologists who proved themselves as pros
in interpreting five other CT scans in this study – saw two of the medical
problems identified by the four expert witnesses hired in the case: a fracture
in one of the vertebrae, and a 1-millimeter widening between one of the
vertebral joints, the latter being at the crux of the lawsuit.

To err is human, to
sue American

The UNC-led study doesn’t point blame at any of the parties
involved. The four paid expert witnesses might have been brilliant, able to see
the subtle 1-mm widening. Or, they might have benefited from hindsight,
identifying the widening on the CT scan after it was clear from subsequent
scans that there was indeed injury to the vertebrae.

At issue, the study’s authors say, is whether there was
negligent standard care. If 31 out of 31 radiologists would have made largely
the same call (19 out of 31 did identify a less-relevant fracture that the paid
experts saw but original radiologist didn’t), then there was no negligence and
no basis of a lawsuit.

The authors conclude using radiologists who are blinded to
both the medical outcome and the litigation may be a more objective way of
determining whether or not the standard of care has been met. This, in turn,
might reduce the number of unwarranted medical
malpractice suits. Ultimately this could reduce health care costs, which
are inflated as a result of medical malpractice premiums, insurance claims, and
medical damages awarded.

The authors also stressed that error is an unavoidable part
of medical practice; that malpractice litigation is necessary to protect
patients from negligence; but that error, or a misdiagnosis, is not synonymous
with malpractice. Seems like a rallying call for blind justice.

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• Original Story: Use of Expert Testimony Questioned in Malpractice

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