This should be getting WAY more attention than it is. Prenuvo tried to limit damages but got shut down. There are so many layers to this lawsuit and what it means for Prenuvo, and people who get these scans. A few thoughts:
- 37 year old man, who I assume is asymptomatic and has no risk factors, gets a preventive Prenuvo whole-body MRI (no medical indication).
- Radiologist is an independent contractor, who allegedly misses a ~60% moderate stenosis/narrowing of the right middle cerebral artery. Though a bunch of other incidental findings are noted.
- Patient has a devastating stroke months later, in the same spot as the original stenosis
- Patient sues Prenuvo, arguing if the stenosis had been appropriately described, the vessel "could have been treated with targeted stenting or other minimally invasive measures, thereby eliminating and preventing the catastrophic stroke."
I read the uploaded Prenuvo report that was given to the patient. To be honest, the entire report reads like AI generated slop with barely any details that I would see in an actual radiologist report, probably because these are just superficial level whole-body MRIs that can't actually evaluate every single organ in a dedicated fashion. It would not give me any comfort.
It does not specifically mention the 60% blockage. It just says "No worrisome intracranial lesion is identified within the brain parenchyma." But what does "worrisome" mean? It is used throughout the report. A moderate 60% blockage is not typically "worrisome" or alarming in the sense that it is not 90% (or severe). But is it enough to warrant aggressive medical therapy and further evaluation? Yes.
But I guess that depends on the definition of "worrisome" and what gets included in the report. Do you include every 20-30% blockage that many of us have, just sitting there not causing issues?
Regarding the actual blockage, I'm not a neurologist but as an interventional cardiologist I make an analogy for the heart. Let's say the stenosis wasn't actually missed. Someone gets a commercial CCTA scan of the heart and is found to have a 60% blockage in an artery. The ultimate question to answer here is - will that blockage actually cause the heart attack 6 months down the road, in the same area? No one can answer that with 100% certainty.
This is a chronic, stable, stenosis, though yes, aggressive at a young age of 37. The patient is asymptomatic, presumably without any known risk factors. The treatment for this is **aggressive medical therapy and lifestyle management**, NOT a stent. Stents **do not prevent** heart attacks for stable disease - aggressive medical management does. You can stent that area but they can still have a heart attack 1 year later at a different location. It is also possible they are treated aggressively with meds and STILL have the heart attack
I rail against "preventive" imaging, but ironically, in this case, this might have actually potentially prevented the stroke in the future. If this 37 year old was treated with aggressive medical therapies and lifestyle management, he may have been able to prevent this tragic outcome. If the patient was not indeed notified, he may not have sought further care, which is even more tragic.
People need to understand what they're getting into when they get these tests. Who is the service? Who is actually interpreting the scan? What does the scan actually mean and not mean for your health? What do you DO when you are handed a copy of your results? WHO is liable? Who do they have to answer to?