Jennifer Drumm had the worstheadacheof her life.
He ordered a CT (computed tomography) scan of Drumm’s brain.
It was around 6 p.m. on a Friday night.
Like many small hospitals, the rural facility did not always have a radiologist on site to interpret scans.
Instead, the hospital had a contract with an outside company, Chambersburg Imaging Associates, to read them.
He ruled out a hemorrhage but found a mass in Drumm’s left temporal lobea possible tumor.
The diagnosis was frightening but not immediately life-threatening.
So, after scheduling a follow-up with an oncologist, the ER gave Drumm painkillers and discharged her.
At 9 p.m., Drumm, a 30-year-old computer technician, drove home.
The ER doctor ordered a more detailed CT, using contrast dye.
And up until a decade or so ago, that’s what would have happened.
Today, that image of doctors conferring in front of a backlit X-ray is as outdated as Marcus Welby.
The result can resemble a perilous game of telephone.
In Drumm’s case, the hospital sent a digital copy of her new scan to Chambersburg Imaging.
At 6:30 a.m. that Saturday, teleradiologist Edward Wong, M.D., opened Drumm’s file.
Dr. Wong’s employer, Virtual Radiologic Consultants, was headquartered in Minnesota.
Dr. Wong was licensed to practice medicine in Pennsylvania.
But as he studied the images of Drumm’s head, he was at his home in Hong Kong.
He saw the mass on his computerand something more.
Come Saturday, yet another radiologist working for Chambersburg Imaging read Drumm’s second CT. With no radiologists raising the alarm, the ER had discharged Drumm again.
But early Monday morning, they found her unconscious on the bathroom floor.
Her abscess had ruptured.
Drumm spent the next 11 weeks in a coma, with shunts draining the fluid from her brain.
She survivedbut with permanent damage to her memory, intellect and ability to function.
The resulting settlement is confidential, and none of the parties was allowed to comment for this story.
At 36 years old, Drumm cannot live on her own and will likely never return to work.
To be sure, teleradiology has significant benefits.
Radiologists may also lack the context necessary to understand what they are seeing.
Now she was doubled over with a sharp pain in her chest.
The radiologist might have used this context to conclude that Icenhower’s surgical complications weren’t over.
Instead, she found nothing urgent.
But it was too late.
“It is a very unusual situation where a radiologist will pick up the phone.”
Perhaps most troubling: How do you know who is reading your scans?
But doctors are expensive, and unethical companies can reap profits by having lower-paid, unqualified technicians read scans.
She didn’t question the story.
“I am a very literal person,” she says.
“You tell me something, I believe it.”
Lo and behold, he spotted something right behind her nipple.
Mizell had early-stage carcinoma in situ.
But 10 of the women, including Mizell, had scans that revealed cancer.
“She must have just flipped,” a former colleague says.
“I don’t know any other way to explain it.”
Rapraeger has vigorously maintained her innocence and pleaded not guilty.
And as the victims, including Mizell, hired lawyers, the questions deepened.
Who was minding the store?
Techs like Rapraeger worked for Perry Hospital, but the doctors named on her phony reports did not.
but who made a series of errors, some life-threatening.
Dr. Shaikh denies all of his former employees' assertions.
Meanwhile, Perry Hospital told Mizell that her original scan had vanished, her complaint alleges.
Two other women were told the same thing.
But if the scans were lost, how could the hospital have known they were positive for breast cancer?
“I was lied to repeatedly.”
Fraud was not confined to Reddy Solutions, says an independent radiologist in Atlanta who worked for Dr. Reddy.
Luckily, the agents agreed that she had been a victim of the scam, not a perpetrator.
State medical boards may come after doctors who take the shortcut for patients covered by private insurers.
There is no guarantee the readers working for these companies would be licensed as doctors in India, either.
“Who’s actually sitting in front of the monitor, and where in the world are they?
Still, administrators must be more aware of the tip-offs to fraud, experts say.
Superior teleradiology companies offer video conferencing between radiologists and clinicians, sometimes patching in the patient.
Patients can encourage more back-and-forth, too.
Is the radiologist credentialed to read it?
Is the facility accredited by a national agency such as the Joint Commission?
you might also quiz your M.D.
on whether she’s talked to the radiologist, reinforcing the idea of communication.
“We like to put together the history,” he says.
Tracey Ehlen and Scott DeNoyer remain crushed that they lost their mother to miscommunication.
“I kick myself for not speaking up.”
If symptoms stick around, see a breast surgeon, who can do a biopsy.
Don’t hesitate to pipe up: Stroke requires treatment ASAP.
MRIs may also miss disks that bulge when you bend your neck.
If you feel neck or arm numbness, ask about an MRI done with the neck inverted.Sara Austin
