Saturday, August 13, 2011

"Canned" Macro Errors-Frustrating at times


Other day, was talking to surgeon friend of mine, who was commenting on another radiologist saying that he was not good, and he said he sometimes had "prostate" n the female patients ultrasound. I just smiled as i knew this was not his fault and was to do with careless review of transcribed report and probably has happened to all of  us at some point of time in a busy practice. Another thing that  i find difficult to manage sometimes is gall bladder in post cholecystectomy status and uterus in post hysterectomy status. Somehow they manage to get onto the reports where should not have been.  Gradually, i replaced uterus/prostate with pelvic viscera to keep it safe. And made the GB line in macro as a blank line so that it does not go normal without my noting it. Although, on careful review it is obvious usually it is a typographical error, but trust me sometimes it is difficult to explain to a patient. Once a friend had a patient who had cholecystectomy and by mistake report had said gall bladder normal, and patient was suspicious that the surgeon did not remove it! and he had a hard time explaining. What are your views on this? All comments and experiences are welcome.

All that can be said is - 
"WE NEED TO BE CAREFUL & WE NEED MORE TRAINED RADIOLOGY ASSISTANTS!"

9 comments:

DrAyushGoel said...

True Sir..
Such errors happen and they are hard to explain.

Sometimes even without a error the patients become curious that something wrong has been done on the part of doctor.

one example i know is
A 40yr old lady came for USG whole abd.
complains suggestive of gall stones with H/O fatty food intolerance

USG done and within 5-10mins report was made saying Multiple accoustic shadows suggestive of gall stones

The patient went to surgeon and on laproscopy surgeon found ABSENT GB

It was indeed a case of GB agenesis.
Now the patient thought of negligence on the part of doctor but the history of medicine says many such blunders in similar cases because it radiologically shows accoustic shadowing despite of absence of GB.

Very Hard To Explain To Patient Such Things.

Anonymous said...

i agree this mistake is very common and happens to all of us very frequently,i have devised two ways --one is to print on the photograph -GB-NIL,UTERUS-NIL etc,OTHER is to write below the photograph(I use thermal paper),GB-X,UTERUS-X,so that the girl will notice these and type correctly.Now such errors have drastically reduced in my reports.
Dr.Ravi Kapoor

Wael Nemattalla said...

Regarding this topic:
One can have a systematic way in obtaining ultrasound pictures so that all abdominal organs are imaged..i.e.
liver, GB, spleen, kidneys, pancreas and so on in pelvic organs. One can then write report from inspecting pictures and if he for example does not find GB in picture so the gallbladder is removed.

Sumer Sethi said...

Thank you for your comments. Yes i agree solution lies in making things systematic. May be noting findings on the film or going in set protocol all the time.

Anonymous said...

Thinking of registering to your blog

Do you accept images from non-radiologists for comment on what is seen
i.e.MRI? [non-contrast]

Just wondering, since it may be educational with a disclaimer that no expectations of a legal diagnosis should be considered
and could be fun...
Of course no patient indentification would be included or accepted.

Thanks for reply to this post

Sumer Sethi said...

reply by-Herbert Kaufman

I learned my lesson many years ago when I was a neophyte radiologist. I reported apical scarring and calcification as an indication of radiographically inactive TB. It was brought to my attention that the report state "active" TB. I have carefully checked every report since and sent out a corrected copy ASAP. With voice recognition now popular, we can be sure our reports are accurate. However, VR is not well accepted by many radiologists as it is time consuming since it does not recognize many words, and many corrections have to be made. In addition, your eyes tend to go from the images to the transcription stream, which I feel can be a detriment to interpretation accuracy.

Steve said...

It would also be better that good and effective communication between patients and docs or other medical staff should be practiced as much as possible. Most patients don't understand a lot of medical terms and sometimes, medical people talk too much jargons. Maybe a more layman's term could do well.


Regards,
Steve
Costa Rica Plastic Surgery

MGK Murthy said...

i think we are forgetting the basic foundation of medicine is based on the clinician and not the tests or tests doctors and ONUS is completely on the clinician to read the report carefully and get back to the erring Radiologist for appropriate rectifications/clarifications
Testimony to this borne out by the fact that our clinical friends like EEG /ECG/NCV/Other readers , like us Write CLINICAL CORRELATION for their own patients at times , and i have been told by them, that explanation , is at that time they are not seeing all together
In Our country , like in other walks of life , Patient should contact the Radiologist

Anonymous said...

Reply by -- Ahmed tayal --IN ,MY PRACTICE, I NOTICED THE PROBLEM, LIKE YOU SAID, EXACTLY, IN THE REFERRING PHYSICIAN, AS WELL AS, HALF EDUCATED PATIENT, BUT TO BE HENEST, NO EXCUSE IN PUTTING PREVIOUSLY EXCISED ORGAN, IN THE PATIENT BODY, ITS AMEDICOLEGAL SERIOUS MISTAKE.

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