Contents

Search

medical malpractice, litigation

Epidemiology: - 49% of physicians have been named in a lawsuit - 41% were involved in suits where other parties were also named - 11% were involved in suits where they were the only person named [5] - among primary care physicians facing lawsuits, 39% have been sued multiple times - > 90% of physicians surprised by the lawsuit - Most common reasons for lawsuit - failure to diagnose or delay in diagnosis 43% - poor outcome, disease progression 25% - failure to treat or delay in treatment 20% - wrongful death 20% - complications from surgery or treatment 15% Notes: - institutional litigation risk has little to do with overall quality of care [1] - malpractice reform alone will not reduce the cost the use of high-cost medical imaging in the emergency department [2] - 1% of all physicians account for 32% of paid malpractice claims [3] - risk for recurrent malpractice claims 4 times as great for neurosurgeons as psychiatrists [3] - communication-&-resolution programs can lower malpractice costs, - identify potential medical errors or outcomes that involve serious potential harm likely to lead to litigation - high-level multidisciplinary assessments of whether mistakes were made & resultant legal exposure - proactive communication with patients & families to disclose & explain errors & potential consequences - offer financial compensation when appropriate - commit to legal defense if no error is believed to have occurred - patients expect specific features [4] - use of term 'reconciliation rather than 'resolution' - information of efforts to improve patient safety because of the error [4] - efforts to reduce malpractice liability have not translated into improved quality of patient care [6]

Related

disclosure of unanticipated outcome medical ethics

References

  1. Studdert DM et al. Relationship between quality of care and negligence litigation in nursing homes. N Engl J Med 2011 Mar 31; 364:1243. PMID: 21449787
  2. Waxman DA et al. The effect of malpractice reform on emergency department care. N Engl J Med 2014 Oct 16; 371:1518 PMID: 25317871
  3. Studdert DM et al Prevalence and Characteristics of Physicians Prone to Malpractice Claims. N Engl J Med 2016; 374:354-362. January 28, 2016 PMID: 26816012 http://www.nejm.org/doi/full/10.1056/NEJMsa1506137
  4. Mello MM, Kachalia A, Roche S et al. Outcomes in two Massachusetts hospital systems give reason for optimism about communication-and-resolution programs. Health Aff (Millwood) 2017 Oct 1; 36:1795. PMID: 28971925 - Moore J, Bismark M, Mello MM et al. Patients' experiences with communication-and-resolution programs after medical injury. JAMA Intern Med 2017 Oct 9; PMID: 29052704 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2656885
  5. Levy S, Kane L. Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits. Medscape. Dec 5, 2017 https://www.medscape.com/slideshow/2017-primary-care-malpractice-report-6009318
  6. Mello MM, Frakes MD, Blumenkranz E, Studdert DM. Malpractice Liability and Health Care Quality. A Review. JAMA. 2020;323(4):352-36 PMID: 31990319 https://jamanetwork.com/journals/jama/article-abstract/2759478 - Sage WM, Underhill K Malpractice Liability and Quality of CareClear Answer, Remaining Questions. JAMA. 2020;323(4):315-317 PMID: 31990297 https://jamanetwork.com/journals/jama/article-abstract/2759452