For the first time in its history, the American College of Radiology has expelled a member for giving inaccurate expert testimony.
Dr. E. James Tourje, a neuroradiologist at Cedars-Sinai Medical Center in Los Angeles, was expelled on Tuesday for violating the ACR code of ethics, which states that expert testimony should be nonpartisan, scientifically correct, and clinically accurate.
The ACR Committee on Ethics had received two separate complaints that Tourje's expert testimony ran egregiously afoul of ACR standards. The committee combined these two cases into a single hearing.
Tourje was invited to appear with counsel before the committee in April but chose instead to defend his testimony with a written response.
The committee asked four independent neuroradiologists to review Tourje's response, court testimony, and relevant diagnostic images. The four experts unanimously agreed that many parts of Tourje's testimony were scientifically inaccurate and clinically incorrect, said Dr. Leonard Berlin, a member of the Committee on Ethics.
The 10-member committee reviewed all material, including the clinical assessment of the outside reviewers, and unanimously decided that in both cases Tourje's testimony violated the ACR code of ethics. Because there were two separate complaints against the same physician, the case warranted the maximum disciplinary action of expulsion, Berlin said.
Tourje was notified of the decision in April and had 60 days to appeal, although he had informed the ACR that he would abide by its decision. Nonetheless, the ACR waited 60 days and sent out an official notice on Tuesday stating that Tourje had been expelled. His name will be entered into the National Practitioner Data Bank.
Tourje did not immediately respond to phone calls.
One complaint against Tourje came from a radiologist involved in a case of a California patient who presented to the hospital ER in 1998 with grand mal seizures, according to Tom Hoffman, associate general counsel for the ACR. The patient subsequently suffered brain damage and sued, claiming the radiologist had misdiagnosed a subdural hematoma.
The radiologist went to trial and received a favorable verdict but felt that Tourje had mischaracterized radiological principles, misinterpreted the MR images, and made several misrepresentations that ran counter to ACR standards and commonly known hospital protocols, according to Hoffman.
The second complaint involved a Florida child with serious head trauma from a bicycle accident in 1996 who subsequently became quadriplegic. Tourje testified that the radiologist had failed to detect a subarachnoid hemorrhage and pressure on the spinal cord. A jury trial found the radiologist not liable.
Counting these two complaints against Tourje, four expert witness grievances have now been resolved by the ACR. In May, the college censured a radiologist who testified as an expert witness in a mammography liability trial. Last October, an expert witness was exonerated when the committee concluded that the testimony was acceptable.
Two cases are pending, and the ACR received two new complaints within the last several months, Hoffman said. A third complaint involving Tourje has surfaced since April, but it now is moot.
The ACR's program to hold expert witnesses accountable grew out of a decision in 2001 by a Chicago federal court to uphold the legality of a decision by the American Association of Neurological Surgeons to suspend a member for engaging in clinically questionable courtroom behavior.
In that case, Chief Judge Richard Posner said that the complainant used his membership in the AANS to boost his credibility as an expert witness.
He wrote: "The Association had an interest -- the community at large had an interest -- in [his] not being able to use his membership to dazzle judges and juries and deflect the close and skeptical scrutiny that shoddy testimony deserves."
"The court basically said that more and not less discipline is needed," Berlin said.
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