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Tail coverage for contrast reaction monitoring
I’m a resident doing the contrast reaction monitoring side hustle for a couple groups who add me on their group malpractice policy. One provides tail coverage and another doesn’t.
What are your thoughts on getting tail coverage for such a small risk exposure? If you think it’s necessary, would you pay out of pocket? -
23 Replies
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people can claim mal-effects from contrast several months down the road, even after you are gone. Just a thought
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A few years ago I would have said: dont bother.
Now that ‘gadolinium poisoning’ is the new asbestosis scam, you need to worry about every MRI chart that may have your name on it (and if its not on the chart, the hyena lawyers will subpoena the payment records of the imaging center because they know that there is another set of deep pockets that can be added to their 20 million suit).-
Good points — I just wonder if my scope is entirely limited to emergent/acute reactions or not. Guess that’s a question for my contract writers or a lawyer.
But a big question is even if those risks are real, are they worth shelling out ~$10k out of pocket on a resident salary?-
I wouldnt cover that facility unless they provide tail. Its not worth getting named in a lawsuit regardless of if it is baseless.
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Unfortunately for me, I’ve already spent a few years working with them starting when I was a dumb R1 not thinking of these things… :/
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The company that we moonlit with as residents in the late 90’s let the malpractice insurance lapse as soon as we stopped working for them and never told us. One of us found out years later during credentialing. The insurance company sent us copies of the letters they sent the locums company insisting that they contact us when they let it lapse but they never did.
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If you find out years later that way, that’s a good thing. Beats having a process server track you down.
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Are they really going to track down a resident months/years later who was just covering gad? I would assume it much easier and more common to just sue the group and rad that signed the report. Medmal is not about choosing the correct target (not that the resident is in this case), it’s about choosing the easy one with the deepest pockets.
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Not necessarily. Its about shotgunning everything that moves and then narrowing down the targets. The lawyers dont care how long or hard it is. They get paid regardless. Even if you are eventually dropped from litigation, being named can be a PITA for credentialing, etc.
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Quote from bald
Are they really going to track down a resident months/years later who was just covering gad? I would assume it much easier and more common to just sue the group and rad that signed the report. Medmal is not about choosing the correct target (not that the resident is in this case), it’s about choosing the easy one with the deepest pockets.
They also name residents who just cross-covered a patient. Anyone they can remotely tie to the patient without any need to prove that the person contributed to the alleged outcome. Some of this is just to gain leverage in negotiations. ‘We drop X, Y and Z if you stipulate (admit) Q, R and S’.-
Yeah I dunno. In the contrast law suits I’ve heard of (which admittedly are reactions and not gad “poisoning”) they simply sue the rad on the report, even when he wasn’t the one on-site monitoring the contrast. Doesn’t even matter if they were at work that day. I’m skeptical of the need for tail insurance in this situation.
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Really? You don’t think that the on-site MD monitoring for contrast reactions and who (presumably) rendered assistance at the time of injection would be named in a lawsuit alleging harm from said injection?
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Yeah if you were covering and something immediately went wrong, sure you’re going to be involved. If we’re talking about you were sitting there each night and never heard anything and you’re worried about some delayed injury – I dont think the resident is likely to be named in the event of “gad poisoning” etc. In that case i think they would just go after the practice and whatever rad was on the report.
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You can get sued for a contrast reaction that you werent on site for, just because you were the one who read the report? I didnt know such a ridiculous scenario was possible. No wonder we have an epidemic of physician burnout with crazy things like that out there
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Is there any record of your monitoring? Do you, the tech, the nurse, or the reporting rad document it?
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Don’t sweat the tail coverage! Since you have nothing but a pile of student loans, the lawyers will leave you alone. It is much easier for them to convince a jury to make an insurance company pay vs making a young physician pay out of his personal assets.
Or, just buy a tail coverage policy yourself. It may be cheap given your limited scope of practice. -
Quote from Suprasellar Cistern
You can get sued for a contrast reaction that you werent on site for, just because you were the one who read the report?
In most cases, the one who signs off on the report is the only one to get sued. This is your practice of medicine, you are billing for ‘supervision and interpretation’. That’s the ‘supervision’ part. -
Interesting, thanks for the clarification. I guess I would have just assumed that the supervision part was bundled into the technical fee that the hospital bills for
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Your lack of net worth wont matter. They can garnish your wages.
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Tort lawyers will likely go after the institution rather than an individual non-boarded physician covering an ambulatory site for the express purpose of treating/preventing acute adverse reactions to contrast.
If you are worried, practice in a state like Tx or Fl with a homestead act (unable to get capital from your primary residence) and inability to go after your retirement. If in the remote chance they have someone aggressive enough to even suggest wage garnishment, convert into LLC and it will kill any chance of them collecting squat.-
This is all nonsense.
If you are going to worry about tail insurance for contrast reactions; my goodnesses, what else are you worrying about? The risk ratio is .0000001%. [Made up coefficient.]
You have much bigger problems than this; maybe you just don’t know them yet.
Forget about it.-
May I suggest Option C: quit the damn gig that’s getting you worried about future liability and enjoy your training days with your spouse/family or enjoy/spend the free time in some other way – learn a language, read, or watch tv or sleep, whatever. This is coming from someone who used up every moonlighting opportunity in my time. 10 years in it seems like such a waste of time – sure I could buy a better gear of some sort at the time, or eat at fancier place. All that hustling doesn’t make you rich. Just aggravation.
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By this logic he should just go bare, but I don’t see anyone arguing that position.
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