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Must New Radiographs Be Compared with All Previous Radiographs, or Only with the Most Recently Obtained Radiographs?

¹ Department of Radiology, Rush North Shore Medical Center, 9600 Gross Point Rd., Skokie, IL 60076, and Rush Medical College, Chicago, IL 60612.

View larger version (126K): [in a new window]   Fig. 1A. —28-year-old woman with history of asthma and complaints of cough, difficulty in breathing, and fever. Posteroanterior chest radiograph obtained on night of admission that was interpreted by defendant radiologists as showing right lower lobe infiltration consistent with pneumonia.

View larger version (134K): [in a new window]   Fig. 1B. —28-year-old woman with history of asthma and complaints of cough, difficulty in breathing, and fever. Posteroanterior (B) and lateral (C) chest radiographs obtained 4 days after A that were interpreted by defendant radiologists as showing no significant change in right lower lobe pneumonia.

View larger version (158K): [in a new window]   Fig. 1C. —28-year-old woman with history of asthma and complaints of cough, difficulty in breathing, and fever. Posteroanterior (B) and lateral (C) chest radiographs obtained 4 days after A that were interpreted by defendant radiologists as showing no significant change in right lower lobe pneumonia.

View larger version (134K): [in a new window]   Fig. 1D. —28-year-old woman with history of asthma and complaints of cough, difficulty in breathing, and fever. Posteroanterior chest radiograph obtained 2 years after B and C shows tumor in right lower lobe. Biopsy specimens revealed mucoepidermoid carcinoma.

View larger version (131K): [in a new window]   Fig. 1E. —28-year-old woman with history of asthma and complaints of cough, difficulty in breathing, and fever. Posteroanterior chest radiographs obtained 3 years (E) and 1 year (F) before A that were originally interpreted by radiologists other than defendants as showing normal findings. Plaintiff's expert radiology witness testified that these radiographs revealed right lower lobe infiltration that was present in subsequent radiographs, and that if these images were seen by two defendant radiologists who interpreted subsequent radiographs, strong suggestion of malignancy would have been considered.

View larger version (144K): [in a new window]   Fig. 1F. —28-year-old woman with history of asthma and complaints of cough, difficulty in breathing, and fever. Posteroanterior chest radiographs obtained 3 years (E) and 1 year (F) before A that were originally interpreted by radiologists other than defendants as showing normal findings. Plaintiff's expert radiology witness testified that these radiographs revealed right lower lobe infiltration that was present in subsequent radiographs, and that if these images were seen by two defendant radiologists who interpreted subsequent radiographs, strong suggestion of malignancy would have been considered.

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