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Based on findings from medical record (MR) review, the radiological care provided to a patient (Patient A) was not consistent with generally accepted standards of medical practice. Specifically, a radiologist working for Little Falls Hospital (LFH) did not accurately interpret x-ray findings while Patient A was in the emergency department (ED).

Findings include:

-- Review of the MR reveals Patient A presented to the ED on 5/20/11 with complaints of right leg pain and inability to bear weight on the right leg. Patient A was status post a fall 10 days prior - the x-ray films obtained during the previous involved ED visit on 5/10/11 were negative for fractures.

An x-ray of the pelvis was obtained on 5/20/11 - interpretation concluded there was no visible fracture, with the impression of mild degenerative changes of the hips bilaterally. The interpretation also noted that if there was persistent pain, an MRI might prove helpful for further evaluation.

-- Department of Health review of the 5/20/11 pelvic x-ray, by a physician board-certified in radiology, has identified that the plain film of the pelvis on 5/20/11 shows a fracture of the right femoral neck (seen as a dense line). The radiology reading of this film at LFH was not accurate - a right femoral neck fracture was missed. The standard of care was not met because an obvious fracture was missed. Also, the radiologist should have compared the study with the prior exam.

Based on findings from document review and interview, the activities of the hospital's quality assurance (QA) program in this case were not adequate. Specifically, a QA review of this case by Little Falls Hospital (LFH) medical staff did not result in identification of the misinterpretation of the radiology film.

Findings include:

-- Review of plain film images of Patient A's pelvis obtained at LFH on 5/20/11 reveals the images were not accurately interpreted by the radiologist involved. See findings in Tag C 283.

-- However, review of the hospital's QA documentation for this case reveals the hospital did not identify that the radiology interpretation of the 5/20/11 x-ray image was not accurate.