Characteristics of Medical Professional Liability Claims in Patients With Cardiovascular Diseases

Oetgen, William J.; Parikh, Parul Divya; Cacchione, Joseph; Casale, Paul N.; Dove, James T.; Harold, John; Hindle, Brenda L.; Maglaras, Michael; Rodgers, George P.; Wright, Janet

doi:10.1016/j.amjcard.2009.10.072

Cited by 35 publications

(16 citation statements)

References 3 publications

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“…Perhaps most surprising, despite being leveled against cardiologists, a significant percentage of claims primarily involve issues that are non-cardiovascular in nature, a finding that distinguishes it from the most complete previous study of cardiovascular claims. 12 Importantly, these claims were most likely to result in indemnity payment – almost a third resulted in payment – and had among the highest average payment sizes and defense costs. In our study, the two most common types of non-cardiovascular lawsuits were patients alleging musculoskeletal injury while under a cardiologist’s care and a failure to diagnose cancer.…”

Section: Discussionmentioning

confidence: 99%

“…It is also an area of concern for policymakers, with estimated annual direct and indirect costs from the liability system (including defensive medicine) of over $55 billion in the U.S. 1 Despite growing evidence on how MPL risk varies according to physician specialty, 2-11 limited data are available on the liability risk faced by U.S. cardiologists, 12-13 specialists for whom the MPL landscape may be particularly complicated. In an analysis of cardiovascular claims in a national registry maintained by the Physician Insurers Association of America (PIAA), 18% of claims closed against cardiologists resulted in indemnity payment to a patient, with an average payment of $248,291.…”

Section: Introductionmentioning

confidence: 99%

“…In an analysis of cardiovascular claims in a national registry maintained by the Physician Insurers Association of America (PIAA), 18% of claims closed against cardiologists resulted in indemnity payment to a patient, with an average payment of $248,291. 12 Diagnostic error was the most common cause of claims, and aortic dissection and aneurysm, while rare clinical events, were most likely to result in payment to a patient. This highly informative study of MPL risk among U.S. cardiologists was limited, however, by its focus on aggregated data across all physicians within a specialty (rather than individual physician-level data) and by its lack of data on cardiologists who were not sued and therefore were not present in the closed claims maintained by the database.…”

Section: Introductionmentioning

confidence: 99%

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Medical professional liability risk among US cardiologists

Mangalmurti

Seabury

Chandra

et al. 2014

American Heart Journal

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Background MPL remains a significant burden for physicians, in general, and cardiologists, in particular, as recent research has shown that average MPL defense costs are higher in cardiology than other specialties. Knowledge of the clinical characteristics and outcomes of lawsuits against cardiologists may improve quality of care and risk management. Methods We analyzed closed MPL claims of 40,916 physicians and 781 cardiologists insured by a large nationwide insurer for at least one policy year between 1991 and 2005. Results The annual percentage of cardiologists facing a MPL claim was 8.6%, compared to 7.4% among physicians overall (p<0.01). Among 530 claims, 72 (13.6%) resulted in an indemnity payment, with a median size of $164,988. Mean defense costs for claims resulting in payment were $83,593 (s.d. $72,901). The time required to close MPL claims was longer for claims with indemnity payment than claims without (29.6 vs 18.9 months, p < 0.001). More than half of all claims involved a patient’s death (304; 57.4%), were based on inpatient care (379; 71.5%), or a involved a primary cardiovascular condition (416; 78.4%). Acute coronary syndrome was the most frequent condition (234; 44.2%). MPL claims involving non-cardiovascular conditions were common (66, 12.5%) and included falls or mechanical injuries suffered while under a cardiologist’s care and a failure to diagnose cancer. Conclusions Rates of malpractice lawsuits are higher among cardiologists than physicians overall. A substantial portion of claims are non-cardiovascular in nature.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Medical professional liability risk among US cardiologists

Mangalmurti

Seabury

Chandra

et al. 2014

American Heart Journal

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“…The data represent approximately 25% of medical malpractice claims in the US and have been used to study malpractice risk in past studies. 14,25–29 …”

Section: Methodsmentioning

confidence: 99%

Medical Malpractice Reform: Noneconomic Damages Caps Reduced Payments 15 Percent, With Varied Effects By Specialty

2014

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The impact of medical malpractice reforms on the average size of malpractice payments in specific physician specialties is unknown and subject to debate. We analyzed a national sample of 220,653 malpractice claims from 1985–2010 merged with information on state liability reforms. We estimated the impact of state noneconomic damage caps on average malpractice payment size for physicians overall and for 10 different specialties, and compared how the effects differed according to the restrictiveness of the cap ($250,000 vs. $500,000 cap). We found noneconomic damage caps reduced payments by $42,980 (15%; p<0.001), with a $250,000 cap reducuing average payments by $59,331 (20%; p<0.001), while a $500,000 cap had no significant effect. Effects varied according to specialty and were largest in specialties with high average payments, such as pediatrics. This suggests that the effect of noneconomic damage caps differs by specialty, and only more restrictive caps result in lower average payments.

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“…Claims against cardiovascular and thoracic surgeons outnumber those against cardiologists, whose claims, in turn, outnumber other internists. These figures represent paid claims to PIAA (Physician Insurers Association of America), which collectively covers 60% of physicians in private practice [1,2].…”

Section: Introductionmentioning

confidence: 99%