Errors of omission

For the first two thirds of the 20th century, the most common bases on which malpractice lawsuits were lodged against physicians were alleged negligent acts of commission-in other words, allegations that the physicians did something wrong [9, 55]. About three decades ago, however, the nature of allegations of negligence against physicians began to undergo a major transformation: instead of being sued for doing something wrong, physicians began to be sued for failing to do something right. In other words, plaintiffs began suing physicians for malpractice far more frequently for negligent acts of omission than for acts of commission. Indeed, Leape et al. [56] found that 75% of all adverse events due to negligence committed in New York hospitals in the late 1980s involved diagnostic mishaps, usually the result of a physician's failure to do something. At approximately the same time, a report of malpractice claims involving the federal government disclosed that a missed diagnosis of cancer had become the most common claim against radiologists, accounting for 30% of all cases [57]. For the past decade, the allegation of failure to diagnose breast cancer has become the most prevalent cause of malpractice lawsuits lodged against radiologists and, in fact, against all physicians in the United States [58]. © American Roentgen Ray Society.