Radiology Malpractice and Missed Infections: When a Bad Scan Leads to Sepsis in Georgia
When a Radiologist Misses an Infection, Sepsis Can Follow
Most people think of radiology errors in the context of missed tumors or overlooked fractures. But radiologists also play a critical role in detecting infections, and when they fail to identify the signs on imaging, the consequences can be far worse than a delayed cancer diagnosis. An infection that goes undetected on a CT scan, chest X-ray, or MRI can progress silently for days or weeks until the patient develops sepsis, a life-threatening condition that kills more hospital patients than most people realize.
Sepsis is the body’s overwhelming response to an infection that has spread beyond the original site. It can cause organ failure, tissue death, and cardiac arrest. According to the Association of American Medical Colleges, it ranks as the third leading cause of death in U.S. hospitals and affects roughly 1.7 million Americans each year. For every hour that treatment is delayed, sepsis mortality rises by an estimated four to nine percent. Up to 80 percent of sepsis deaths may be preventable with timely care.
When a radiologist misreads or dismisses findings that point to an active infection, the clock starts ticking against the patient. And in Georgia, that kind of oversight may amount to malpractice.
How Radiologists Fit Into the Infection Diagnosis Process
Radiologists do not examine patients directly. They receive imaging orders from emergency physicians, hospitalists, surgeons, and primary care providers, and their job is to interpret those images and communicate findings back to the treating team. In infection cases, that process often begins in the emergency room, where a physician orders a chest X-ray for a patient with fever and shortness of breath, or a CT scan for someone presenting with severe abdominal pain.
The radiologist reviews the images, dictates a report describing what they see, and assigns an impression, which is the clinical conclusion. If the scan reveals signs of pneumonia, a spinal epidural abscess, or a deep organ abscess, the radiologist is expected to flag those findings clearly. In urgent situations, the standard of care may also require a direct phone call to the ordering physician so that antibiotics or surgical drainage can begin without delay.
This system works well when every link in the chain does its job. It fails when the radiologist either does not see the abnormality or sees it but describes it in vague terms that do not convey urgency. Both scenarios can lead to an infection going untreated long enough to cause sepsis.
Common Infection-Related Misses on Imaging
Not every infection is easy to spot on a scan. Some findings are subtle, especially in the early stages. But certain patterns are well-documented in radiology literature as frequent sources of error, and a competent radiologist reading the same images should catch them.
Subtle Pneumonia
Pneumonia does not always present as an obvious white consolidation on a chest X-ray. In its early stages, it may appear as a faint haze in one lung field, particularly behind the heart or near the diaphragm where overlapping structures can obscure the view. A radiologist who reads the film too quickly or fails to compare it with prior imaging may dismiss this as normal variation or atelectasis, which is a minor and usually harmless partial collapse of lung tissue. When that happens, the patient may be sent home without antibiotics, and the pneumonia can worsen into a bilateral infection or progress to sepsis within days.
Spinal Epidural Abscess
A spinal epidural abscess is one of the most commonly missed infections in medicine. Research suggests that it goes undiagnosed in over 60 percent of cases on initial presentation. On MRI, the infection typically appears as a collection of fluid or enhancement around the spinal cord, but if the radiologist is focused on disc disease or degenerative changes, the abscess can be overlooked entirely. A missed spinal abscess can lead to permanent paralysis if the infection compresses the spinal cord, and sepsis if the bacteria enter the bloodstream.
Deep Organ Abscesses
Abscesses in the liver, kidney, pelvis, or retroperitoneum can develop after surgery, trauma, or a worsening urinary or gastrointestinal infection. On CT, they usually appear as fluid collections with a surrounding rim of enhancement. However, they can be confused with benign cysts, post-surgical fluid, or even normal bowel contents if the radiologist does not apply contrast appropriately or fails to correlate with the patient’s clinical picture. A missed abdominal abscess may rupture or seed bacteria into the bloodstream, triggering sepsis or septic shock.
Post-Surgical Infections
Patients who have recently undergone surgery are at heightened risk for infection, and imaging is often the first tool used to evaluate new symptoms like fever, increasing pain, or wound drainage. A radiologist reviewing post-operative imaging must distinguish between expected healing changes and early signs of infection, such as gas in soft tissues, new fluid collections, or rim-enhancing abscesses. Misinterpreting these findings as routine can cause dangerous delays in surgical re-intervention or IV antibiotics.
The Difference Between a Difficult Read and Negligent Oversight
Radiology is not a perfect science. Approximately four percent of imaging interpretations contain some degree of error, and not every miss constitutes malpractice. Georgia law does not hold radiologists to a standard of perfection. It holds them to the standard of care, meaning what a reasonably competent radiologist, practicing in the same specialty, would have identified under similar circumstances.
The distinction between an understandable miss and a negligent one often comes down to a few factors. Was the finding visible on the images that were available? Were prior comparison studies available, and did the radiologist review them? Did the radiologist follow accepted protocols for the type of study being read? Was the report clear enough to communicate the level of concern? And were peer practice patterns consistent with catching that type of finding?
When an independent expert reviews the same images and concludes that a reasonably careful radiologist should have flagged the infection, that gap between what was reported and what should have been reported becomes the foundation of a malpractice claim.
How Radiology Experts Review Imaging in Malpractice Cases
In Georgia medical malpractice cases, the law requires an expert affidavit from a qualified physician at the time of filing. For cases involving radiology errors, that expert is typically a board-certified radiologist who practices in the same subspecialty as the defendant.
The expert review process involves obtaining the original DICOM image files, not just the printed or PDF versions of the radiology report. DICOM files allow the expert to scroll through every slice of a CT scan or MRI, adjust windowing and contrast settings, and view the images exactly as the original radiologist would have seen them. This level of access is critical because some findings are visible only on certain contrast settings or in specific planes.
The expert also reviews the radiology report, any addenda, communication logs, and the ordering physician’s notes to determine whether the radiologist communicated findings adequately. In some cases, the imaging clearly shows an abnormality that the report never mentions. In others, the report uses hedging language like “cannot exclude” or “clinical correlation recommended” without conveying the urgency needed for the treating team to act.
An experienced malpractice attorney will also request prior imaging studies, because comparison films are often the key to proving a miss. If a CT scan from three months earlier shows a small fluid collection and the follow-up scan shows a larger, enhancing collection in the same location, the failure to note the progression becomes much harder to defend.
When a Missed Infection Becomes Sepsis
The danger of a missed infection on imaging is not just the infection itself. It is the cascade that follows when treatment is delayed. An untreated pneumonia can seed bacteria into the bloodstream. A spinal abscess can erode into surrounding tissue. An abdominal abscess can rupture. In each of these scenarios, the patient may develop sepsis, which escalates rapidly through a predictable but devastating progression.
Sepsis begins when the immune system overreacts to the infection, releasing chemicals into the bloodstream that trigger widespread inflammation. Blood pressure drops. Organs begin to fail. Without aggressive treatment including IV antibiotics, fluid resuscitation, and sometimes surgical intervention, the patient can progress from sepsis to septic shock, which carries a mortality rate that can reach 50 percent.
The connection between the radiology miss and the eventual harm is what lawyers call causation. To build a successful case, an attorney must show that if the radiologist had correctly identified the infection, earlier treatment would have prevented or significantly reduced the harm. In many infection-to-sepsis cases, that link is strong because the medical literature is clear: early detection and treatment of the source infection is the single most important factor in preventing sepsis progression.
Communication Failures That Compound the Error
A radiologist’s responsibilities do not end with dictating a report. When imaging reveals a critical or unexpected finding, the radiologist has an obligation to communicate that finding directly to the treating physician in a timely manner. Many hospitals have formal critical results reporting policies that require the radiologist to make a phone call or send an electronic alert within a specified time frame.
When that communication fails, even a report that correctly identifies an infection can lead to harm if the ordering physician never sees it. This is especially common in high-volume emergency departments, where patients may be transferred, discharged, or handed off to a new physician before the radiology report is finalized. It is also an issue with teleradiology, where the interpreting radiologist may be reading images from a remote location and has no direct relationship with the patient’s care team.
These communication breakdowns do not excuse the radiologist. Under Georgia law, the radiologist has an independent duty to ensure that critical findings reach the right people. A report sitting unread in the medical record does not satisfy that duty when the patient’s condition is deteriorating.
Who Can Be Held Responsible
Medical malpractice cases involving radiology errors and missed infections often involve more than one defendant. Depending on the facts, potentially responsible parties may include the radiologist who misread the imaging, the teleradiology company that employed the radiologist, the hospital or imaging center where the study was performed, and the ordering physician who failed to follow up on ambiguous or concerning results.
Georgia allows claims against individual providers as well as the entities that employ or contract with them. In some cases, a hospital’s failure to implement adequate critical results reporting policies or to staff its radiology department with qualified readers may give rise to separate claims for institutional negligence.
Identifying every potentially responsible party early in the process is important because it affects which insurance policies are available to compensate the patient and which entities have a legal obligation to preserve records and imaging data.
What You Can Do If a Later Doctor Says the Scan Was Wrong
It is not uncommon for a patient to learn about a radiology miss only after the damage has been done. A second emergency room visit, a hospitalization for sepsis, or a consultation with a specialist may reveal that the earlier imaging showed the infection all along. When a later physician tells you that something was visible on a prior scan that was not reported, that statement matters.
If you find yourself in that situation, there are practical steps you can take to protect yourself and preserve your options.
- Request copies of all prior imaging studies, including the actual image files on disc or through the hospital’s patient portal, not just the written radiology reports.
- Ask the physician who identified the error to document their findings in your medical record, including a specific reference to the prior study and what they believe was missed.
- Keep a written record of your symptoms, treatments, and any conversations with your medical team about the earlier imaging.
- Do not delay in seeking legal advice, because imaging files and digital records can be overwritten, archived, or lost if preservation is not requested promptly.
Georgia’s statute of limitations for medical malpractice imposes strict filing deadlines, and certain circumstances may shorten the time you have to act. An early consultation with an attorney experienced in radiology cases can help ensure that all relevant records and images are preserved while you focus on your health.
Why Early Legal Review Matters in These Cases
Radiology malpractice cases involving missed infections require a level of medical and technical expertise that sets them apart from many other types of negligence claims. The imaging must be reviewed by a qualified expert. The clinical timeline must be reconstructed to show when treatment should have begun and how the delay affected the patient’s outcome. And the records, including DICOM image files that may be stored on hospital servers with limited retention periods, must be preserved before they disappear.
These cases also tend to involve large damages because the harm from sepsis can be catastrophic. Patients who survive septic shock often face prolonged ICU stays, multiple surgeries, amputations, organ damage, and long-term rehabilitation. Families who lose a loved one to sepsis that should have been caught on imaging face both the emotional devastation and the financial burden of medical bills and lost income.
A peer-reviewed study in the American Journal of Roentgenology found that diagnostic errors account for roughly 75 percent of all malpractice claims filed against radiologists, and the average indemnity payment in radiology cases exceeds $450,000. When the missed finding is an infection that leads to sepsis, the stakes and the potential recovery are often much higher.
Talk to a Georgia Medical Malpractice Attorney
If you or someone in your family suffered from sepsis or a serious infection that a later physician says should have been caught on earlier imaging, you deserve clear answers about what went wrong and what your options are. A consultation can help you understand whether the evidence supports a claim and what the process of investigation looks like.
Davis Adams is an Atlanta-based medical malpractice firm that handles radiology error and infection cases across Georgia. If you would like to discuss your situation, contact us for a confidential consultation.
