Evaluation of a national database of completed investigations into radiology service complaints in New Zealand: What can the radiologist, and radiology service providers, learn?

Introduction: The Health and Disability Commissioner (HDC) is responsible for dealing with most complaints from service users resulting from their interactions with a healthcare service provider in New Zealand. We analysed all published reports involving a radiologist or radiology service in order to gain insights that might promote safer working across the radiology community.

Methods: We searched the entire HDC online report database choosing a limit of 'radiologist' as occupation.

Results: Twenty-seven investigations were included, published between 1999 and 2021. Seventeen (63%) involved private radiology providers and 10 (37%) involved public providers. Ultrasound featured in 12 cases (44%), x-ray 6 (22%), CT 5 (19%), mammography 2 (7%), MRI 1 (4%) and interventional 1 (4%). Obstetric ultrasound accounted for 9 (75%) of the ultrasound cases. In 24 (89%) cases, the HDC felt an error had been made. Of the 34 radiologists investigated, 21 (62%) were found in breach of the HDC code, with adverse comment made regarding 4 (12%). A total of 46 incidences of different error types were identified including: communication 14 (30%), perceptual 11 (24%), technical 8 (17%) and interpretative 7 (15%). Forty-five incidences of contributing factors were identified, including organizational 9 (20%) and clinical information provided 7 (16%).

Conclusion: Errors in radiology practice, leading to complaints, are often multifactorial and systemic. Reflection on the myriad of error types and contributing factors (including 'human factors') is imperative to reduce errors. Multifaceted strategies are likely required for radiologists to enhance their systems and practice.