Training, disclosures are key to lowering ultrasound legal risks.(Obstetrics)

KAILUA KONA, HAWAII -- Clinicians who offer fetal ultrasounds in their offices should ensure that those performing the scans are properly trained and that they explain to patients the limitations of the technology, to reduce the risk of being sued over ultrasound results, several speakers said at a conference on obstetrics, gynecology, perinatal medicine, neonatology, and the law.

In recent years, sonographers and ultrasound technicians who used to work exclusively for radiologists have been hired by some obstetricians to do ultrasounds in their offices. Many malpractice suits arising from misinterpretation or mismanagement of fetal ultrasound derive from inadequate staffing, training, and education, said Kimberly D. Baker, J.D.

She said too many clinicians want to have a fully equipped office technologically but are unwilling to pay for the education and training needed to maximize use of the technology. Turf wars make it more common for radiologists and other experts to criticize obstetricians or general practitioners whose use of ultrasound contributes to a legal case, said Ms. Baker, a defense lawyer in Seattle who also holds a BS degree in nursing.

"If you are going to have someone in your office who does this, you need to make sure that they are adequately trained, that their status is updated, that they are educated, and that you have a quality review process for your staff," she advised.

Dr. Dolores H. Pretorius noted during a question-and-answer session that the American Institute of Ultrasound in Medicine offers a voluntary set of credentialing mechanisms for physicians who perform ultrasound. "I think it is helpful to have that to defend yourself," said Dr. Pretorius, professor of radiology and director of imaging at the University of California, San Diego.