Diagnostic Radiologist Fails To Identify Colorectal Cancer From MR Scan

This case involves a 54-year-old male patient who presented with persistent abdominal pain, constipation, and blood in his stool. He was admitted and given an MR scan of the pelvis but the diagnostic radiologist read the scans as normal. He was given a laxative medication and discharged with no follow-up scheduled. The patient continued to cope with persistent bowel discomfort for the next few months. The patient eventually returned to the hospital with extreme bowel discomfort and significant rectal bleeding. A subsequent pelvic MR scan revealed advanced stage colorectal cancer. The patient eventually succumbed to his cancer. It was alleged that the diagnostic radiologist failed to identify the patient’s cancer when it was still treatable. An expert in diagnostic radiology was asked to perform a blind review of the first MR scan of the pelvis and determine if the cancer was identifiable and treatable at this stage.

Question(s) For Expert Witness

1. Please briefly describe your experience reviewing pelvis MR scans.

Expert Witness Response E-092332

I am fellowship trained in abdominal and pelvic MR imaging at a prestigious university-affiliated hospital. I currently serve as the division director of MR at a local community hospital where I have worked for 14 years as a staff radiologist. I spend about 20% of my time reading general MR, a portion of which includes abdominal and pelvic MR. My research and publications include the analysis of pelvic MR scans, specifically rectal cancer imaging.