Characteristics of medical malpractice claims involving emergency medicine physicians

Abstract

Background: Identifying characteristics of malpractice claims involving emergency medicine (EM) physicians allows leaders to develop patient safety initiatives to prevent future harm events. Methods: A retrospective study was performed of paid/unpaid claims closed 2007 to 2016 from Comparative Benchmarking System. Claims were identified by physician specialty involved (EM, internal medicine, general surgery). Various characteristics were compared by physician specialty. Multivariable regression was performed to identify factors associated with claim payment, in which (1) physician specialty was included as a predictor and (2) only the subset involving EM physicians was analyzed. Results: Of 54,772 claims, 2760 involved EM physicians, 5886 involved internists, and 3207 involved surgeons. Death was the most common severity among EM claims (34%). Diagnosis-related allegations accounted for 58%, higher than 42% and 11% of claims involving internists and surgeons, respectively (P < 0.0001). Thirty-one percent was paid. The median indemnity paid on behalf of any defendant was $206,261 (interquartile range $55,065-527,651). The most common final diagnoses were myocardial infarction (2%), pulmonary embolus (2%), and cardiac arrest (2%). Procedure-related claims were associated with increased payment likelihood (odds ratio 1.21, 95% confidence interval 1.10-1.34). Conclusion: Malpractice claims in EM are often diagnosis-or procedure related. Our findings suggest that diagnostic accuracy and procedural competency should shape future quality improvement work.

Impact of the COVID pandemic on emergency department CT utilization: where do we go from here?

“…However, this ED CT utilization is similar compared to like institutions, including only adult EDs (32/100), those with 80 k–100 k annual ED visits (32/100), and level 1 or 2 trauma centers (31/100) [ 21 ]. Additionally, the local medicolegal environment in Illinois as well as concerns regarding diagnostic accuracy likely contribute to increased ED diagnostic test utilization [ 44 , 45 ]. An additional limitation is that our analysis focuses on presentation to the ED and is not able to capture those patients who may have been evaluated in the outpatient setting by primary care or other providers as well as may have sought evaluation in private outpatient only radiology centers, both of which could have provided a perception of safer, less risky care.…”

Medical Malpractice and Diagnostic Errors in Japanese Emergency Departments

“…Several previous studies reported that the judgment for the plaintiff rate was 13.3% in the ED setting for medical malpractice in Taiwan 21 and 31% in 2020 in the US. 11 Diagnostic errors were involved in 35–37% of the medical lawsuits in the ED in the US. 22 , 23 This is considerably lower than the rate in Japan (68.5%).…”

“… 20 According to three studies of US medical lawsuits, the most common final diagnoses related to diagnostic errors in the ED are acute myocardial infarction, appendicitis, pulmonary embolism, and fractures. 11 , 22 , 23 …”

“…In other countries, there have been several investigations of medical malpractice in the ED, suggesting that diagnostic errors and procedural problems contribute to malpractice. [11][12][13] However, few studies have examined diagnostic error-related malpractice in Japanese EDs.…”

„Medical Screening“ von Notfallpatienten mit psychiatrischen Symptomen

“…In einer weiteren Umfrage benennen Notfallmediziner als Hauptgrund die Angst, eine Diagnose mit geringer Wahrscheinlichkeit zu verpassen (69%) und die Sorge vor möglichen Rechtsstreitigkeiten (64%; [31]). Eine retrospektive Kohortenstudie von Arzthaftungsansprüchen von Notfallmedizinern aus den USA berichtet, dass mehr als die Hälfte der Verfahren sich aus möglichen Fehlern von diagnostischen Prozeduren ableitet [32]. Obwohl das juristische Vorgehen in den USA sicherlich nicht auf die mitteleuropäische Situation übertragbar ist, geben diese Untersuchungen einen interessanten Einblick.…”