A company contracted with Carilion Clinic hospitals to interpret X-rays over the Internet has agreed to pay $500,000 to the estate of a Roanoke man who died after a physician failed to diagnose his internal bleeding.

In agreeing to the settlement, Nighthawk Radiology Services denies liability for any negligence in the death of 47-year-old Jay Lynn Brandon in 2007.

Brandon's death "was a huge tragedy," said Dan Frith, who filed the wrongful death lawsuit in September on behalf of Brandon's mother. "It didn't need to happen."

Brandon died from an aneurysm in his chest that ruptured. Had he received surgery, the odds are excellent that he would still be alive today, Frith said.

The original lawsuit named both Nighthawk and Carilion as defendants, but Carilion was dropped after evidence showed Carilion's staff was not at fault, Frith said.

According to the suit, the afternoon of March 25, 2007, Brandon went to the emergency room at Carilion Roanoke Memorial Hospital with chest pain and back pain.

The year before, Brandon had been diagnosed with an aneurysm in his chest, but at the time it wasn't life-threatening. The emergency room doctor ordered an X-ray to have another look at the aneurysm. "Basically, the emergency room physician did everything he was supposed to do," Frith said.

That day the hospital didn't have a qualified radiologist on site to examine the results, so the emergency physician relied on the service provided by Nighthawk. Brandon's X-rays were e-mailed to a physician in Louisiana, Dr. Thomas Vreeland, who concluded that the aneurysm had not changed. Based on Vreeland's interpretation, Brandon was given prescriptions for pain and nausea, told to make an appointment with his family doctor and sent home.

Five days later, Brandon's mother found him dead in his home. The cause of death proved to be the ruptured aneurysm.

According to the lawsuit, the new X-rays did show evidence that the aneurysm was bleeding. Vreeland, when interviewed for a deposition, could not provide a definitive reason for the missed diagnosis, Frith said.

Carilion began relying more heavily on Nighthawk's services last year after the valley's largest group of radiology doctors moved most of their practice to Lewis-Gale Medical Center. Some doctors criticized the move, while others said it improved Carilion's performance.

In relying on outsourced radiology diagnoses, Carilion is not unique. More than a thousand hospitals and radiology groups nationwide make use of Nighthawk.

"It's a big issue, this off-site reading by teleradiologists," Frith said. "People go to hospitals to be taken care of, and they don't always know who's behind the curtain taking care of everybody."

A spokesman for Nighthawk did not return a call seeking comment Thursday afternoon.