In a medical malpractice lawsuit, medical experts educate the court about the care at issue and offer opinions on whether it met the standard of care. Their testimony can affect a physician’s career and a patient’s opportunity for compensation. Both deserve an opinion that can withstand close review.
A radiologist expert witness should explain what the images show, what information was available to the treating physician, what standard of care applied at the time, and what evidence supports the opinion. The expert’s qualifications must also match the specific issue being reviewed.
Expert witnesses are subject to checks and balances. Courts can exclude their opinions, and professional societies can suspend or expel them, undermining their credibility in future cases. Testimony under oath can also lead to medical board sanctions, including license suspension or revocation, potentially costing the expert their own ability to practice medicine.
These historical cases show those measures in practice.
1. Testimony must be scientifically correct and clinically accurate.
In 2004, a radiologist expert alleged negligence after a patient developed kidney failure following two contrast CT scans performed 14 minutes apart. His personal theory of cumulative contrast toxicity relied on his own experience without supporting published evidence. The ACR found his testimony scientifically incorrect and clinically inaccurate and suspended his membership for 80 days. It also announced that the suspension would be reported to the National Practitioner Data Bank.
ACR disciplinary action involving Dr. Darwood B. Hance, 2004.
2. Qualifications must fit the procedure being challenged.
In May 2004, a Texas appellate court directed dismissal of a malpractice case involving brain hemorrhage after brain tumor embolization. The radiologist expert testified that the procedure should have been aborted because of the tumor’s blood supply. The court found that the expert’s report and CV did not establish the expertise needed to judge that procedure’s standard of care. Radiology credentials alone did not establish his qualifications for this opinion.
In re Windisch, No. 07-04-0018-CV, May 27, 2004.
3. Imaging descriptions and claims of causation must be accurate.
In two malpractice cases involving cervical and subdural hematomas, the ACR found that a neuroradiologist expert witness gave incorrect testimony about causation and misrepresented MRI images and ACR standards. After reviewing both complaints, the ACR expelled him from membership.
The available public reporting does not include the imaging or detailed testimony needed to clarify the issues further.
ACR disciplinary action involving Dr. E. James Tourje, 2004.
4. The claimed standard must apply when the care occurred.
An expert testified that an abnormal mammogram required a six-month follow-up recommendation. The ACR found that this was not the applicable ACR standard when the care occurred in 1994 and privately censured the expert. An expert must accurately describe the recommendations in effect at the time.
ACR private censure reported in 2004.
5. Expert testimony can lead to medical license discipline.
In a case outside radiology, the North Carolina Medical Board revoked a neurosurgeon expert witness’s North Carolina license in 2002 over testimony it interpreted as an unsupported accusation that a treating neurosurgeon had falsified a medical record. The penalty was later reduced to a one-year suspension. In 2006, an appellate court overturned the discipline and ordered the charges dismissed, finding that the expert had a good-faith evidentiary basis to question the treating neurosurgeon’s note.
In re Lustgarten, North Carolina Court of Appeals, June 6, 2006.
These cases involved different consequences: rejection of an expert report, professional society discipline, and action against a medical license.
Disagreement alone does not establish misconduct. In the same contemporary reporting, the ACR described two complaints involving minority opinions that resulted in no finding of an ethical violation. Review must distinguish a defensible disagreement from an inaccurate statement.
Attorneys should expect an expert’s opinions to withstand the same scrutiny as the care being challenged. Physicians serving as experts should be prepared to explain and defend their own statements.
Defendant physicians with evidence of materially inaccurate or misleading testimony should consider submitting a documented complaint to the appropriate professional society or medical board. Although testimony is given within an individual lawsuit, it can be examined through an external peer-review or disciplinary process.
In my own work providing diagnostic radiology expert witness services, I begin with an imaging review before learning the alleged miss or later outcome whenever feasible. I then review the clinical record. I keep my opinions within my practice area: imaging of the chest, abdomen, and pelvis.
Whether retained by the plaintiff or defense, I explain my conclusions, acknowledge their limits, and revise them when new evidence warrants. Upholding expert witness accountability and professional standards is the foundation of my practice.
To discuss a potential case or request a consultation, please contact me today.
