Nature of Medical Malpractice Claims Against Radiation Oncologists

Abstract

Purpose/Objective(s) We examined characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. Methods and Materials Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression. Results There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38 million in indemnity payments. The most common alleged errors included: ‘improper performance’ (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity); ‘errors in diagnosis’ (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity); and, ‘no medical misadventure’ (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. ‘Improper performance’ was the primary alleged error associated with injury resulting in death. Compared to claims involving death, major temporary injury (OR 2.8, 95% CI 1.29–5.85, P=0.009), significant permanent injury (OR 3.1, 1.48–6.46, P =0.003) and major permanent injury (OR 5.5, 1.89–16.15, P =0.002) had higher likelihood of a claim resulting in indemnity payment. Conclusions Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims against radiation oncologists may help direct efforts to improve quality of care and minimize the risk of being sued.

Root Cause Analysis of Oncology Adverse Events in the Veterans Health Administration

“…1,10,[17][18][19][20] Most current literature pertaining to oncologic errors and adverse events has been based on closed claims malpractice data. 10,21,22 In those data, the primary reasons for litigation include failure to diagnose and treat, patient injuries, and failure to adhere to safety protocol. 10,21,22 Existing literature reports oncologic errors and adverse events in specific areas of oncology, including errors in chemotherapy and radiation.…”

“…10,21,22 In those data, the primary reasons for litigation include failure to diagnose and treat, patient injuries, and failure to adhere to safety protocol. 10,21,22 Existing literature reports oncologic errors and adverse events in specific areas of oncology, including errors in chemotherapy and radiation. [4][5][6][7][8][9][10][11][12][13] Multiple studies revealed that medication errors, including ordering the wrong dose and failure to follow protocol when administering the drug, were the most commonly reported adverse event type in chemotherapy.…”

An analysis of medical malpractice claims against medical oncologists from a national database: Implications for safer practice

“…This outcome was selected as it was deemed by the authors relevant to motivating practice change and had face validity as a marker of malpractice environment, as well as consistency with methods used in other studies of malpractice environment. 11,[22][23][24] We chose variables a priori to include in the model. For claimant age, the odds ratio is per year.…”

Predictors of Medical Malpractice Outcomes After Spine Surgery

“…Large privately owned databases managed by insurance associations have been used in medicolegal studies for other conditions and represent another potential source of data for malpractice litigation, however, these databases typically contain coded data using standardized definitions which limits the depth of information for each case. [20][21][22][23][24] In the absence of a single centralized, comprehensive database of all malpractice claims in the United States, Westlaw represents one of the best publicly available sources of malpractice data. This study defined search parameters for cases from 2010 to 2019, in order to capture comprehensive trends in spine litigation of the last decade.…”

“…Therefore, the cases in our study should be considered a subset of all malpractice claims involving spine surgery, specifically those that were deemed to have sufficient basis for trial involving higher monetary claims, which may be of greater relevance for physicians hoping to identify methods to improve patient care while reducing malpractice liability. Large privately owned databases managed by insurance associations have been used in medicolegal studies for other conditions and represent another potential source of data for malpractice litigation, however, these databases typically contain coded data using standardized definitions which limits the depth of information for each case 20–24. In the absence of a single centralized, comprehensive database of all malpractice claims in the United States, Westlaw represents one of the best publicly available sources of malpractice data.…”