Malpractice Claims on Emergency Physicians: Time and Money

Cohen, D.; Chan, S.B.; Dorfman, M.

doi:10.1016/j.jemermed.2008.06.014

Cited by 22 publications

(8 citation statements)

References 14 publications

(11 reference statements)

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“…; however, certain general trends have emerged. Recent studies have found a greater risk of malpractice payments among patients less than age one (Cohen, Chan, & Dorfman, 2012;Kain, 2006). Several studies have also found that payments associated with in-court judgment are higher than those associated with out-of-court settlement (Chandra et al, 2005;Kane, 2011;Studdert et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Catastrophic Medical Malpractice Payouts in the United States

Bixenstine

Shore

Mehtsun

et al. 2014

Journal for Healthcare Quality

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Catastrophic medical malpractice payouts, $1 million or greater, greatly influence physicians' practice, hospital policy, and discussions of healthcare reform. However, little is known about the specific characteristics and overall cost burden of these payouts. We reviewed all paid malpractice claims nationwide using the National Practitioner Data Bank over a 7-year period (2004-2010) and used multivariate regression to identify risk factors for catastrophic and increased overall payouts. Claims with catastrophic payouts represented 7.9% (6,130/77,621) of all paid claims. Factors most associated with catastrophic payouts were patient age less than 1 year; quadriplegia, brain damage, or lifelong care; and anesthesia allegation group. Compared with court judgments, settlement was associated with decreased odds of a catastrophic payout (odds ratio, 0.31; 95% confidence interval [CI], 0.22-0.42) and lower estimated average payouts ($124,863; 95% CI, $101,509-144,992). A physician's years in practice and previous paid claims history had no effect on the odds of a catastrophic payout. Catastrophic payouts averaged $1.4 billion per year or 0.05% of the National Health Expenditures. Preventing catastrophic malpractice payouts should be only one aspect of comprehensive patient safety and quality improvement strategies. Future studies should evaluate the benefits of targeted interventions based on specific patient safety event characteristics.

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Section: Introductionmentioning

confidence: 99%

Catastrophic Medical Malpractice Payouts in the United States

Bixenstine

Shore

Mehtsun

et al. 2014

Journal for Healthcare Quality

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“…The adverse outcomes that result from medical errors are associated with a significant number of medical malpractice claims and financial liability 2,3 . Prior studies have found that the ED contributes to a substantial share of preventable adverse injury and associated financial liability within the health care system 4–6 …”

mentioning

confidence: 99%

An Epidemiologic Study of Closed Emergency Department Malpractice Claims in a National Database of Physician Malpractice Insurers

Brown

McCarthy

Kelen

et al. 2010

Academic Emergency Medicine

185

103

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Objectives: The objective was to perform an epidemiologic study of emergency department (ED) medical malpractice claims using data maintained by the Physician Insurers Association of America (PIAA), a trade association whose participating malpractice insurance carriers collectively insure over 60% of practicing physicians in the United States.Methods: All closed malpractice claims in the PIAA database between 1985 and 2007, where an event in an ED was alleged to have caused injury to a patient 18 years of age or older, were retrospectively reviewed. Study outcomes were the frequency of claims and average indemnity payments associated with specific errors identified by the malpractice insurer, as well as associated health conditions, primary specialty groups, and injury severity. Indemnity payments include money paid to claimants as a result of settlement or court adjudication, and this financial obligation to compensate a claimant constitutes the insured's financial liability. These payments do not include the expenses associated with resolving a claim, such as attorneys' fees. The study examined claims by adjudicatory outcome, associated financial liability, and expenses of litigation. Adjudicatory outcome refers to the legal disposition of a claim as it makes its way into and through the court system and includes resolution of claims by formal verdict as well as by settlement. The study also investigated how the number of claims, average indemnity payments, paid-toclose ratios (the percentage of closed claims that resolved with a payment to the plaintiff), and litigation expenses have trended over the 23-year study period.Results: The authors identified 11,529 claims arising from an event originating in an ED, representing over $664 million in total liability over the 23-year study period. Emergency physicians (EPs) were the primary defendants in 19% of ED claims. The largest sources of error, as identified by the individual malpractice insurer, included errors in diagnosis (37%), followed by improper performance of a procedure (17%). In 18% of claims, no error could be identified by the insurer. Acute myocardial infarction (AMI; 5%), fractures (6%), and appendicitis (2%) were the health conditions associated with the highest number of claims. Over two-thirds of claims (70%) closed without payment to the claimant. Most claims that paid out did so through settlement (29%). Only 7% of claims were resolved by verdict, and 85% of those were in favor of the clinician. Over time, the average indemnity payments and expenses of litigation, adjusted for inflation, more than doubled, while both the total number of claims and number of paid claims decreased.Conclusions: Emergency physicians were the primary defendants in a relatively small proportion of ED claims. The disease processes associated with the highest numbers of claims included AMI, appendicitis, and fractures. The largest share of overall indemnity was attributed to errors in the diagnostic process. The financial liability of medical malpractice in t...

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“…O tempo limitado, a imprevisibilidade e a falta de continuidade da relação médico-paciente são as possíveis geratrizes do alto risco jurídico dessa área médica 13 . Estudo realizado no Tribunal de Justiça do Rio Grande do Sul (TJ-RS) apontou que as situações de urgência e emergência eram preditoras para a judicialização dos casos naquele estado 9 .…”

Section: Discussionunclassified

Entendimento do Tribunal de Justiça do Pará sobre o erro médico na esfera penal

2017

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Introdução: O processo por erro médico costuma ter impacto profundo tanto na vida profissional como na vida pessoal do médico. Entretanto, como a judicialização da medicina é recente, carece de estudos com análise dos fatos a partir da dupla perspectiva da Medicina e do Direito. Objetivo: Analisar os processos da esfera penal do Tribunal de Justiça do Pará. Métodos: Foi realizada uma pesquisa por palavra-chave no site do Tribunal de Justiça do Estado do Pará (TJPA) com o termo de pesquisa: “erro médico”. Resultados: Foram encontrados 42 julgados jurisprudenciais. Desses, 24 foram excluídos, pois: 4 eram repetições; 19 eram crimes não cometidos por médicos e 1 por tratar de difamação. Ocorreu uma prescrição e três processos ainda não haviam sido julgados na primeira instância. Dos 14 processos julgados, houve 6 condenações e 8 absolvições. A distribuição por especialidades se deu da seguinte maneira: 8 na ginecologia-obstetrícia (GO); 4 na emergência clínica; 2 na cirurgia geral; 1 em anestesiologia/cirurgia plástica; 1 em oftalmologia; 1 em ortopedia; e 1 em radiologia. Conclusão: Os casos de acusação de supostos erros cometidos por médicos no exercício de suas especialidades ainda são raros no panorama geral do Pará. As especialidades ligadas à cirurgia e às situações de emergência, principalmente GO, foram as principais envolvidas nesse tipo de processo.

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Malpractice Claims on Emergency Physicians: Time and Money

Cited by 22 publications

References 14 publications

Catastrophic Medical Malpractice Payouts in the United States

Catastrophic Medical Malpractice Payouts in the United States

An Epidemiologic Study of Closed Emergency Department Malpractice Claims in a National Database of Physician Malpractice Insurers

Entendimento do Tribunal de Justiça do Pará sobre o erro médico na esfera penal

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