Missed radiology handoff sparks two lawsuits + policy change

The Washington Hospital Center in Washington, D.C., has agreed to change the way that patients are admitted for brain imaging procedures, in response to a lawsuit by a brain-injured patient whose family says she was left without a physician for several hours while she was having an undetected stroke after a procedure in the hospital's radiology department.

When Lyn Gross underwent a procedure in June 2003 to treat an aneurysm in her brain, the radiologist who conducted the procedure listed her in the hospital record as being the patient of a neurosurgeon who was unaware of the patient. When she showed signs of developing a stroke after the procedure, treatment for the stroke was delayed for several hours because of confusion over who was supposed to be her main doctor, according to a press release provided by Washington, D.C.-based Patrick Malone & Associates, the patient’s law firm.  

In settling the lawsuit brought on her behalf by her husband, Paul Gross, the family asked the hospital as a condition of the settlement to agree that the interventional radiologists who do procedures on patients would not have authority to list another doctor as the attending physician, unless that doctor knew about the patient in advance and consented to be the patient's doctor. The hospital agreed to implement a new policy in the 2007 settlement.

Gross filed a second lawsuit against the hospital earlier in 2012, saying the hospital had never confirmed its new policy, and he asked the Superior Court to enforce the settlement. That prompted a letter from Janis M. Orlowski, MD, Washington Hospital Center’s chief medical officer, confirming that the policy has been implemented.

The letter read:

“At the time of Mrs. Gross’ procedure, the interventional radiologist was permitted under the hospital’s credentialing to admit his/her patients to the hospital. Accordingly, no arrangements for follow-up care by a neurosurgeon were required. This has changed as a result of the Gross v. Washington Hospital Center settlement.”

The hospital credentialing committee in 2007 revoked radiologists’ credentials to admit patients to the hospital. Interventional procedures require that the radiologist communicate with the neurosurgery service to notify neurosurgery of the patient’s existence in the hospital and of the requirement to assume admitting responsibility for the patient. Under the new policy, neurosurgery is responsible for the patient’s post-procedure care while in the hospital.