ACR expels member for improper lawsuit testimony

Jul 8, 2004

For the first time since it began investigating complaints about expert witnesses in malpractice lawsuits, the American College of Radiology has expelled a member for giving testimony that the college found to be improper.

Dr. E. James Tourje, an attending staff radiologist and neuroradiology specialist with Cedars-Sinai Health System in Los Angeles, had been a full ACR member since 1977. The Reston, VA-based college announced Tourje's expulsion on its Web site this week.

The action came after the organization's Committee on Ethics determined that Tourje had provided "biased, scientifically incorrect, and clinically inaccurate testimony" in violation of the college's code of ethics, according to attorney Thomas Hoffman, the committee's staff counsel.

Tourje's case was unusual in that the college received two separate complaints regarding his testimony in two different lawsuits. Both of the defendant radiologists were cleared of malpractice in their respective cases, Hoffman said.

In the case of a child injured in a 1996 bicycling accident, Tourje incorrectly stated that the radiologist's failure to diagnose an alleged cervical hematoma led directly to the patient's becoming a quadriplegic, Hoffman said.

Then, in a 1998 lawsuit involving a radiologist's alleged failure to timely diagnose a subdural hematoma that caused brain damage, Tourje reportedly misrepresented the MRI images and ACR standards in his testimony.

Since the ACR first began soliciting complaints about expert-witness testimony in July 2002, the college has received nine complaints regarding eight ACR members, Hoffman said. Five of those complaints regarding four members have now been resolved.

Much of the challenge for the ethics committee appears to be distinguishing differences of opinions from inaccuracy.

"We've had (two) cases where the testimony was a little bit off the beaten track; it was opinionated, it represented a minority rather than a majority opinion," observed committee member Dr. Leonard Berlin of Rush North Shore Medical Center in Skokie, IL.

"Nevertheless, the committee did not feel in those cases it actually crossed the line in violating the ethical standards," Berlin added. "I think the committee is doing a very good job in trying to be very fair-minded, giving the benefit of the doubt to the radiologist."

In a third case, the ethics committee recently issued a private censure against a member who testified that a defendant radiologist should have called for a six-month follow-up in his report on an abnormal mammogram. Such follow-up was not the ACR's standard of care as of 1994, when the case occurred.

In reviewing Tourje's testimony, the ethics committee opted for the greater and ultimate disciplinary action of expulsion.

"The committee ruled unanimously, after hearing all of the evidence, that there was a significant violation of the ethics, in view of the fact that there were myriad issues and statements made in both cases, and in view of the fact that there were two cases, not one case," Berlin said.

"We're talking about incorrect statements, not differences of opinion," said Berlin of Tourje's testimony. "It was just medically incorrect."

According to the Cedars-Sinai Web site, Tourje is an American Board of Radiology-certified radiologist who graduated from the University of Minnesota Medical School, and who completed his residency and neuroradiology fellowship at the same institution.

"I've never talked with him, but obviously he's a highly credentialed, excellent radiologist," Berlin said. "I have no doubt about that."

Tourje did not appear before the ACR ethics committee, nor did he appeal its decision. He did not respond to an AuntMinnie.com request for comment on the ACR's conclusions.

While the ACR's action doesn't affect Tourje's right to practice, it will likely have the intended effect of preventing any further appearances as an expert witness.

"Any defense attorney worth their salt would research and challenge Dr. Tourje's credibility in court based on a professional society's actions," Hoffman said.

By Tracie L. Thompson
AuntMinnie.com staff writer
July 9, 2004

AMA delegates chastise doctor for suggesting care refusal to plaintiff attorneys, June 14, 2004

ACR weighs more allegations over expert testimony, April 27, 2004

'Threatening' article to mammo expert throws malpractice case into disarray, December 16, 2003