A couple has filed a civil suit against a New England radiologist, claiming he missed signs of an impending stroke on CT angiography. Jeffrey and Kim Sayward formally filed the malpractice complaint in a U.S. District Court in Maine on May 15. The couple alleges that radiologist Eric J. Sax, MD, MBA, FACR, then providing services to MaineHealth Hospital in Biddeford, failed to identify a dangerous clot during an incident three years ago.
What the complaint says
According to the document filed in federal court, the clot described by the couple was at risk of dislodging and blocking the blood supply to the patient brain, posing imminent danger. The suit argues that, as a result of the allegedly negligent read, the 63-year-old man was discharged from the hospital. Nine hours later, the account says, the clot dislodged and progressed into a devastating stroke, leaving the patient with permanent injury.
Along with MaineHealth, attorneys also name Spectrum Healthcare Partners as a co-defendant. The Portland-based medical practice provides imaging interpretations to hospitals across Maine. The complaint states that Dr. Sax was working for the practice at the time, noting he currently resides in Massachusetts and works at Tufts Medical Center in Boston, according to public records.
The clinical timeline
The Saywards describe themselves as snowbirds — Florida travelers who spend their summers in Maine. On the morning of May 29, 2023, Jeffrey Sayward suffered an episode of syncope in the region. An ambulance took him to the emergency department of what was then Southern Maine Health Care, now renamed MaineHealth Maine Medical Center Biddeford. He arrived at the ED shortly after 10 a.m. and was triaged as emergent.
An attending emergency physician ordered a CT angiogram of the head and neck under stroke protocol to evaluate for life-threatening pathology. Imaging was acquired between 11:20 and 11:34 a.m., and the final report was electronically signed by Dr. Sax at 11:48 a.m. The suit alleges the radiologist failed to highlight a critical abnormality on the images: high-grade stenosis consistent with the appearance of a clot. The report, the document states, recorded the left vertebral artery as without evidence of stenosis.
The clinical outcome
The hospital discharged the patient around 12:57 p.m., attributing his lightheadedness to probable dehydration after a round of golf in the sun the day before. Around 7 p.m., however, the patient suddenly felt weak and unwell. The couple called 911, and the patient was transferred to MaineHealth Level 1 trauma center in Portland because of his serious condition. A new CTA showed that he had in fact suffered a stroke.
Comparison with the morning images, according to the complaint, revealed that Dr. Sax had missed a clot in the left vertebral artery. The patient was hospitalized for a week and required a lengthy inpatient rehab stay. Despite extensive physical and occupational therapy, he is left with permanent impairment. The family claims extraordinary medical expenses, pain and suffering, loss of enjoyment of life, and permanent injury. They are seeking unspecified damages in excess of $75,000, with the final tally likely much larger.
The legal context and why this case stands out
The case takes on additional relevance because, according to plaintiff attorneys, it is among the first medical malpractice cases filed in Maine federal court after a recent U.S. Supreme Court decision. In January, the Court allowed a federal lawsuit in Delaware to proceed even though it did not meet procedural requirements for malpractice cases under that state superior court rules. The interpretation opens the door for similar challenges in other jurisdictions.
Elizabeth Kayatta, the attorney representing the couple, sees the lawsuit as a chance to set precedent in Maine, a state known for strict screening before malpractice suits reach state superior courts. To her, a win against the radiologist could bring greater public transparency around medical errors. The Maine Health Security Act, in her view, shrouds in secrecy the majority of malpractice cases moving through the state system.
Implications for radiology practice
Cases like this reinforce several points for the radiologist covering emergency shifts. The first is the importance of explicit communication of critical findings, even when they already appear in the report. In stroke protocols, equivocal values justify direct contact with the attending physician and documentation of the conversation. The second point is the use of checklists for the vertebral arteries, a segment frequently associated with perceptual errors on CTA. The third is documentation of the time elapsed between image acquisition and report, increasingly used as a quality metric.
These cautions intersect with technology advances. As we covered in our story on AI in pulmonary embolism detection on CTPA with real-world performance, automated tools can serve as a safety net against perceptual misses on emergent findings. Societies such as ACR already recommend that high-volume services consider these support layers. The case also connects to the broader discussion of the public role of radiology, already explored in our coverage of the Saphier nomination to U.S. Surgeon General.
What is pending and what comes next
Dr. Sax did not respond to the local newspaper that first reported the suit. MaineHealth and Spectrum Healthcare Partners also declined to comment. The lawsuit will likely have a long path, with expert phases centered on a review of the images and opinions from specialists in vascular neuroimaging. For radiologists outside the U.S., the case is a reminder that detailed documentation of diagnostic reasoning, plus contact with the ordering physician, remains the strongest defense against litigation involving missed findings.
Source: Radiology Business
