Statute of limitations and the continuum of care doctrine.

A 65-year-old woman was referred by her family physician to a free-standing radiology facility for screening mam-mography. The findings on the mammograms were interpreted by a radiologist as normal except for " mild fibrocystic changes. " One year later, the physician again referred the woman to the same radiology facility for screening mam-mography. On this occasion, the same radiolo-gist interpreted the findings as normal except for " mild fibrocystic changes, unchanged since previous mammography 1 year ago. " Eight months later, the woman consulted her family physician because she noticed a lump in her left breast that appeared soon after her husband had accidentally struck her on the breast with a golf club. The physician examined the woman's left breast and found a lump, which he believed was due to the golf club incident. Nonetheless, the physician ordered a mammogram. The same radiologist who had interpreted findings on the woman's two previous mammograms as normal now interpreted the findings on the new mammo-grams as revealing microcalcifications in the left breast that were suspicious for carcinoma. The report was communicated to the family physician by telephone and in writing. However , the physician failed to inform the patient of the suspicious findings. Eight months later the patient, noticing that the lump was growing, again consulted her physician. A biopsy, quickly obtained, disclosed infiltrating ductal carcinoma. Despite aggressive treatment that included surgery, radiation, and chemotherapy, the patient died 16 months after the diagnosis was established. Three days before the patient's death, the woman and her family filed a malpractice lawsuit against the family physician and the radiologist. The lawsuit charged the family physician with negligence for failing to advise her that the findings on the mammogram obtained after the golf club injury had been suspicious for carcinoma, resulting in an 8-month delay in the cancer diagnosis. The lawsuit charged the radiologist with negligence for misinterpreting the patient's second screening mammogram—the one that had been obtained 16 months before the diagnosis of breast cancer had been established. The family physician and the radiologist had separate professional liability insurance carriers and defense attorneys. I will focus on the allegation of malpractice directed at the defendant ra-diologist and on the unique medical–legal issue it raised, the doctrine of continuum of care. In the documents outlining the details of the alleged malpractice, the attorney for the plaintiff included an affidavit executed by an expert radiology witness …