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Francis Deng, MD Profile picture
Francis Deng, MD
@francisdeng
Neuro/head & neck radiologist | Asst Prof @Hopkins_Rad | educator, editor, podcaster interested in diagnostic excellence
4 subscribers
Dec 18, 2023 • 24 tweets • 8 min read
Reading this malpractice case, part 2: expert witness statements and deposition testimony from physicians (names redacted)🧵
(part 1, the claim from plaintiffs, quoted) Noncontrast head CT was performed at 4:08AM.
Reason for study: "R/O bleed"
Wet read given to neurology resident at 4:15AM: no acute intracranial hemorrhage.
Brief prelim report in EMR at 4:33AM. Image
Dec 17, 2023 • 10 tweets • 4 min read
One of the largest malpractice awards ever just dropped:
"Hospital on the hook for $120M jury verdict after residents miss signs of stroke on CT"


Always interested in learning from diagnostic error, I looked up the court documents.🧵pt1 (names redacted)radiologybusiness.com/topics/healthc… A 41 year old man without significant past medical history is last seen well at 10pm as his wife went to bed (he stayed up to play video games)

He's discovered unresponsive at 3am when the wife is awoken by a loud bang:
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May 14, 2022 • 8 tweets • 4 min read
"The general rule in acute dizziness and vertigo is that if you need neuroimaging, it should be by MRI, rather than CT."

Pearls and pitfalls in diagnostic stroke in acute dizziness/vertigo: ahajournals.org/doi/pdf/10.116…
🧵for case example👇 This older adult presented to clinic with several episodes of dizziness in the preceding month (off-balance, not room spinning), then a day of gait imbalance, left hand incoordination, and left lip numbness.

Head CT was obtained urgently (Reason: "*Dizziness, non-specific"):
Nov 11, 2020 • 20 tweets • 7 min read
Do the benefits outweigh the risks in using MRI gadolinium-based contrast media (GBCM) in patients with kidney disease?

MAJOR new consensus statement from @RadiologyACR and @NKF published in @Radiology_RSNA at doi.org/10.1148/radiol…

A #RadInTraining #TWEETORIAL thread 👇 BACKGROUND:
GBCMs consist of gadolinium ions chelated with organic ligands to minimize toxicity from free gadolinium.

Which chemical class has a lower rate of free gadolinium dissociation?
Apr 9, 2020 • 20 tweets • 8 min read
You are seeing a patient with suspected #COVID19. When is imaging (CXR or CT) indicated?

A #TWEETORIAL summary of the Fleischner Society consensus statement @Radiology_RSNA: doi.org/10.1148/radiol…
Podcast: doi.org/10.1148/radiol…
#RadsInTraining Step 1: Assess the severity of respiratory disease.

A) is there hypoxemia?
B) is the patient's dyspnea and work of breathing significant?
Oct 14, 2019 • 48 tweets • 21 min read
Acute allergic-like reactions to intravascular iodinated contrast: Who's at risk and how do you reduce the risk?

A #TWEETORIAL for #radres and referring clinicians alike

Inspired by a recent paper in @Radiology_RSNA by Cha MJ, Kang DY, et al. pubs.rsna.org/doi/10.1148/ra… 1/40ish @radiology_rsna First some background:

DEFINING ALLERGIC-LIKE REACTIONS
Which of the following is most likely to represent an allergic-like contrast reaction?