XRAY mis-diagnose (Accord: appointed, law, reassessment) - New York City - New York (NY) - City-Data Forum

plugin918 · 05-07-2014, 02:48 PM

My mon slipped on the platform at a subway station about a month ago and got black and blue all over her shoulders and legs. She was suspected that she has some fractures on the shoulder and she could not lift up her arm at all. On the day after the incident, she went to see her family doctor and was refer to take an XRay; According to the medical center where she to the XRAY, it revealed that the result was positive, which mean there's no fracture indication.

And since the XRay result is positive, her family doctor send her for the physical therapy treatment. The doctor also said if the XRay reveal there fracture, she definitely CAN NOT go for physical therapy because it will made the situation worse.

After 2 weeks of physical therapy treatment, she still not getting any better on her arm and instead it was getting worse. She went back to her family doctor and the doctor send her to MRI to check the injured arm. And this time the MRI result in fact reveal there're fracture in her bone...

So I am wondering should I blame on the Medical Center who took the XRAY and carelessly gave faulty result and consequence lead to wrong treatment (she shouldn't do physical therapy at all if she has fracture), which made the situation even worse than before. What is the right action to take if protect patient's right should the Medical Center has any responsibility to this?

Please advise. Thanks.

newtoli · 05-07-2014, 02:51 PM

Sometimes an xray cannot detect minute fractures. Which is why when the injury did not improve with PT, they opted for a more expensive MRI. This is not malpractice or fault on the part of the doctor, it's a reasonable path to diagnosis.

30to66at55 · 05-07-2014, 02:57 PM

No Money for You

brooklyn1234 · 05-07-2014, 10:22 PM

First of all, if a doctor orders an x-ray, they are not the only ones who read the x-ray. The medical center would have had a radiologist read it- a radiologist is an MD who has specialized in reading diagnostic tests (x-rays, MRIs, CTs, etc). The results would then be sent to your family doctor- usually both a copy of the images and a copy of the radiologists report. It's highly unlikely that the x-ray showed a fracture and it was missed by both the radiologist and your family doctor. The other poster above was likely correct in that it was a small micro-fracture that became apparent in the weeks after the injury.

Second, the doctor took the correct action here. According to you the x-ray showed no fracture, and per the doctor's expertise physical therapy was indicated. It only became apparent after several weeks of PT that there was a further problem. Upon seeing the doctor again he immediately ordered an MRI, at which time a fracture was diagnosed. It doesn't sound like there was any carelessness or negligence here.

There is one part of your story that is a little bit troubling though- typically when a fracture IS present the x-ray is said to be positive. If no fracture was present it would be negative. Are you sure you didn't misunderstand the results somehow? If you're really concerned I would suggest you order a copy of the x-ray results from the medical center and read them yourself.

In the end please remember- medicine is NOT an exact science. What happened to your mother is unfortunate, yes. But aside from making a quick buck what would come out of you suing the doctor or medical center? If they made a gross mistake (i.e. there is a clear huge fracture on the x-ray and they said there wasn't one) then that's one thing. But if it's what it sounds like (i.e. that there was a minor/undetectable fracture and the doctor followed the proper protocol for diagnosis and treatment), you should be grateful that the doctor had the foresight to identify the correct test to follow up, make the correct diagnosis and avoid further complications.

oh, and an fyi disclaimer: I'm not a doctor, but I've worked in orthopedics for 5 years.

plugin918 · 05-08-2014, 09:27 AM

Quote:

Originally Posted by brooklyn1234

First of all, if a doctor orders an x-ray, they are not the only ones who read the x-ray. The medical center would have had a radiologist read it- a radiologist is an MD who has specialized in reading diagnostic tests (x-rays, MRIs, CTs, etc). The results would then be sent to your family doctor- usually both a copy of the images and a copy of the radiologists report. It's highly unlikely that the x-ray showed a fracture and it was missed by both the radiologist and your family doctor. The other poster above was likely correct in that it was a small micro-fracture that became apparent in the weeks after the injury.

Second, the doctor took the correct action here. According to you the x-ray showed no fracture, and per the doctor's expertise physical therapy was indicated. It only became apparent after several weeks of PT that there was a further problem. Upon seeing the doctor again he immediately ordered an MRI, at which time a fracture was diagnosed. It doesn't sound like there was any carelessness or negligence here.

There is one part of your story that is a little bit troubling though- typically when a fracture IS present the x-ray is said to be positive. If no fracture was present it would be negative. Are you sure you didn't misunderstand the results somehow? If you're really concerned I would suggest you order a copy of the x-ray results from the medical center and read them yourself.

In the end please remember- medicine is NOT an exact science. What happened to your mother is unfortunate, yes. But aside from making a quick buck what would come out of you suing the doctor or medical center? If they made a gross mistake (i.e. there is a clear huge fracture on the x-ray and they said there wasn't one) then that's one thing. But if it's what it sounds like (i.e. that there was a minor/undetectable fracture and the doctor followed the proper protocol for diagnosis and treatment), you should be grateful that the doctor had the foresight to identify the correct test to follow up, make the correct diagnosis and avoid further complications.

oh, and an fyi disclaimer: I'm not a doctor, but I've worked in orthopedics for 5 years.

Hello,

Thanks for the details explanation. It does help me to see a little bit more insight about the formal process when something happen like this.

First of all, let me correct myself. The xray report did indicate there's no fracture and it is 'NEGATIVE' and I agree that the family take the appropriate action for ordering PT for her (if the family doctor has also check the xray and confirmed it upon).

However, the story does not end there... and thing now it is getting more complicate than what I have described in my early post. I hope I can describe the developing story clearer as the follow:

So after 2 weeks of PT and my mon's shoulder didn't get any better, the PT (not the family doctor) suspected that there may be fractures and the PT recommended her go back to the family doctor and ask for a detail examination. So then the family doctor send her to ANOTHER medial center where she has her MRI taken. And the MRI revealed there's fracture and muscle issue (the muscle is teared off...) on her shoulder, as a normal procedure, the MRI center called the clinic (on MAY 6th) and told them the MRI result, and the clinic called her immediately asked her to come back to the clinic to see the family doctor for the follow up. When the receptionist from the clinic called her on MAY 6th, the receptionist did told her that the MRI center called and the report indicate there problem with her shoulder.

My mon set up an appointment to go back to the family doctor on May 7th, but before that, in the afternoon on MAY 6th after the called, she went to the XRAY Medical Center and asked for a copy of the XRAY and the report. And here is where things is going to get very suspicious.......

On the morning of MAY 7th, my mon went back to the clinic, before seeing the doctor, she has been waiting in the room for about 45 mins and she has pleasure chat with the receptionist (there're 2 receptionists, let's say receptionist A and receptionist B) in the front desk. Receptionist A was the one who called on May 6th regarding the MRI result, before seeing the doctor, reception A still admit saying the result from the MRI has came back and the doctor want to see her to discuss the report...; however, when my mon called in to see the doctor, the doctor denied that they has the MRI report, and tried to convince her that the call was from the XRAY medical center NOT the MRI one...

My mon was confused at that moment, she was so sure that receptionist A told her that they got the MRI report and the doctor want her come in for a follow up. Even before seeing the doctor, she was continues the conversation with reception A. But now the doctor was changed his word and deny it.

On the way out, my mon was trying to talk to receptionist A again to get a clear picture on what was going on; however, receptionist B was tried to jump into the conversation and stop her from getting more detail. She was still trying to convince her that they didn't receive anything from the MRI center... But thanks god that receptionist B did insist they did get the report from MRI and she gave my mon a copy of it.

My mon was so angry and brought the MRI report back to the doctor and question him why he denied he got the report. And.... he was speechless and got an embarrass looking face.

TIMELINE OF THE EVENT:
1. April 17th, she slipped, has shoulder injured
2. April 17th, went to see family doctor immediately
3. April 17th, sent to XRAY Medical Center for exam
4. April 18th, XRAY report indicated no fracture and no muscle tear off
5. April 18th, family doctor send her to Physical Therapy
6. April 19th - May 4th, after 2 weeks of PT, she still not getting any better, and still cannt lift up her arm
7. May 4th, PT doctor recommend her to do an MRI
8. May 5th, she got an MRI done in the MRI Medical Center, (Not the XRAY one)
9. May 6th, she got a call from family doctor's clinic, they told her they got the MRI result and indicate a problem and ask her to come back for an follow up
10. May 6th, she went to the XRAY Medical Center and inquire for a copy of the XRAY photo
11. May 7th, she went back to the family doctor; However, the doctor denied they didn't get report from MRI, but they get a report from XRAY Medical Center indicate that there's fracture and muscle issue on her shoulder
12. May 7th, she got a copy of the MRI report from front desk receptionist
13. May 7th, she went to the doctor and ask why he denied the MRI report, he was speechless.

Personally, I felt that the doctor and the XRAY were working together to cover some fact in this case. I guess their motivation is behind the afraid that we are going to sue the XRAY center. I personally now believe that the XRAY center re-examine the XRAY result after my mon request for a copy and they found there in fact there's problem indicate from the XRAY result but they didn't see it the first time. Therefore, they called the family doctor and ask him to covert the true and denying they got the result from the MRI center.

My mon was so depressed and disappointed at this moment, she has been with this doctor for the past 10 years, she couldn't believe she would be betray like this.

Right now, we got both the copy for the XRAY and the MRI and also the reports. I am still not sure what action I will take next; however, I don't think I can simply let them go like this easily. I mean, as a doctor, I believe they violate the basic ethical manner by covering the true in order to protect their own benefit.

I am seeking advise and collecting opinions on what is the right thing to do next for the following reasons:
1. Raise awareness of the public that the dark side of the medical system and we should do something about it
2. I believe that both XRay Medical and the Family Doctor should take responsibility for their lying the true
3. Give back fair treatment to patient who encounter similar issue by bring up attention to the public about medical malpractice in some clinics

Thanks.

mc33433 · 05-08-2014, 09:33 AM

This is not necessarily a NYC question, though it happened in NYC, so you may want to check out a forum on law advice or healthcare questions....

MissionIMPOSSIBRU · 05-08-2014, 10:39 AM

From what information you've provided so far, it seems to me like your family doctor simply hadn't been updated of the MRI report, which is hardly something to get overly upset about.

He would have nothing to gain from covering up his knowledge of the report because, if both he and the duty radiologist had been negligent in failing to spot the fracture on the original X-ray, they'd be liable for damages whether the MRI report existed or not.

Ultimately, plain X-rays are not 100% reliable, and they commonly miss minor avulsion fractures of the type your mother suffered. That's why physiotherapists are trained to pick up on patients who fail to make progress and send them back for reassessment.

In most cases, if a fracture is too small to be detectible on a plain X-ray, it is not likely to be significant enough to greatly affect the long-term consequences for your mother if it gets missed.

nybbler · 05-08-2014, 11:10 AM

An X-ray will not show muscle issues, so the doc had the MRI report. He may have thought it came from the same medical center as the xrays but that's hardly a significant mistake. Bottom line is no one did anything wrong, there's no betrayal, and your mom needs to be treated and not worry about who got what report. I bet once she's in less pain she'll be a whole lot less depressed and disappointed.

(And I say this as I sit with multiple fractures myself; pain makes you angry and depressed.)

deeken · 05-08-2014, 11:16 AM

Quote:

Originally Posted by 30to66at55

No Money for You

LOL, you are and odd fellow.

purpleprincess22 · 05-08-2014, 11:19 AM

You are going to give yourself an ulcer and are trying to find a conspiracy when none exists. Fractures are missed on xrays all the time. This is why people get MRIs when pain persists. The MRI report likely hadn't been put in your mom's file yet so the doctor didn't know about it. A lot of times a midlevel handles forwarded imaging reports and labs and sometimes it can take a day or two for the reports to make it into the patient files.