Urological Malpractice: Analysis of Indemnity and Claim Data From 1985 to 2007

Benson, Jonas S.; Coogan, Christopher L.

doi:10.1016/j.juro.2010.05.034

Cited by 26 publications

(20 citation statements)

References 8 publications

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“…This is a group of companies, which between them provide insurance protection to >60% of private practitioners in the USA, and write ≈46% of the total industry premium. The PIAA’s summary data of claims for urology from 1985–2007 showed a total of 5 577 claims with $285 million paid during the 22‐year study period[5]. The average paid per claim was $174 245 which, using exchange rates at the time of writing, is more than double that in the present study.…”

Section: Discussioncontrasting

confidence: 40%

Urological litigation in the UK National Health Service (NHS): an analysis of 14 years of successful claims

Osman

Collins

2011

BJU International

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• Most of the claims were related to non-operative events (232), followed by postoperative events (168) and intraoperative events (92).• The most common reason for nonoperative-related claims was failure to diagnose/treat cancer (69), perforation/ organ injury (38) was the highest intraoperative-related claim and a forgotten ureteric stent (23) was the most frequent postoperative-related claim.• The five most commonly implicated procedures were ureteroscopy/ureteric stenting (45), transurethral resection of the prostate (30), nephrectomy (26), vasectomy (19) and urethral catheterisation (15). CONCLUSIONS• The present study once again emphasizes the importance of thorough clinical assessment, record keeping and follow-up as well as informed consent and good communication with patients.• Recognising the areas of highest risk and improving practice should limit future claims. KEYWORDS urological litigation, National Health Service (NHS), malpracticeWhat's known on the subject? and What does the study add? There are no previous studies for urology in the UK but several studies from physician insurance groups in North America. There is anecdotal evidence of common reasons for litigation, e.g. missed testicular torsion. This is the first analysis of the claims data compiled by the NHS litigation authority for the speciality of urology; it provides realistic insight into the areas and procedures of the speciality most commonly affected by litigation.The article identifies areas of high risk, both clinical and medico-legal. OBJECTIVES

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Section: Discussioncontrasting

confidence: 40%

Urological litigation in the UK National Health Service (NHS): an analysis of 14 years of successful claims

Osman

Collins

2011

BJU International

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“…11-13 A recent American Medical Association (AMA) survey of physicians showed that 5% of respondents had faced a malpractice claim during the previous year. 14 Studies estimating specialty-specific malpractice risk from actual claims are much less recent, 15,16 including a Florida study from 1975 through 1980 showing that 15% of medical specialists, 34% of obstetricians and anesthesiologists, and 48% of surgical specialists faced at least one claim that resulted in an associated defense cost or payment to a claimant (an indemnity payment) during the 6-year study period.…”

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confidence: 99%

“…Each of these earlier studies has limitations, including the use of older data 15-17 with limited geographic coverage, 17 reliance on self-reports with limited sample size and low response rates, 14 limited information on physician specialty, 13,14 and a lack of information on the size of payments. 14 Although the National Practitioner Data Bank includes most cases in the United States in which a plaintiff was paid on behalf of a licensed health care provider, 18 it does not report the specialties of physicians and does not record information on cases that do not result in a payment.…”

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confidence: 99%

Malpractice Risk According to Physician Specialty

et al. 2011

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Background Data are lacking on the proportion of physicians who face malpractice claims in a year, the size of those claims, and the cumulative career malpractice risk according to specialty. Methods We analyzed malpractice data from 1991 through 2005 for all physicians who were covered by a large professional liability insurer with a nationwide client base (40,916 physicians and 233,738 physician-years of coverage). For 25 specialties, we reported the proportion of physicians who had malpractice claims in a year, the proportion of claims leading to an indemnity payment (compensation paid to a plaintiff), and the size of indemnity payments. We estimated the cumulative risk of ever being sued among physicians in high- and low-risk specialties. Results Each year during the study period, 7.4% of all physicians had a malpractice claim, with 1.6% having a claim leading to a payment (i.e., 78% of all claims did not result in payments to claimants). The proportion of physicians facing a claim each year ranged from 19.1% in neurosurgery, 18.9% in thoracic–cardiovascular surgery, and 15.3% in general surgery to 5.2% in family medicine, 3.1% in pediatrics, and 2.6% in psychiatry. The mean indemnity payment was $274,887, and the median was $111,749. Mean payments ranged from $117,832 for dermatology to $520,923 for pediatrics. It was estimated that by the age of 65 years, 75% of physicians in low-risk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties. Conclusions There is substantial variation in the likelihood of malpractice suits and the size of indemnity payments across specialties. The cumulative risk of facing a malpractice claim is high in all specialties, although most claims do not lead to payments to plaintiffs. (Funded by the RAND Institute for Civil Justice and the National Institute on Aging.)

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“…surgical specialists faced at least one claim that resulted in an associated defense cost or payment to a claimant (an indemnity payment) during the 6-year study period. 17 Each of these earlier studies has limitations, including the use of older data [15][16][17] with limited geographic coverage, 17 reliance on self-reports with limited sample size and low response rates, 14 limited information on physician specialty, 13,14 and a lack of information on the size of payments. 14 Although the National Practitioner Data Bank includes most cases in the United States in which a plaintiff was paid on behalf of a licensed health care provider, 18 it does not report the specialties of physicians and does not record information on cases that do not result in a payment.…”

mentioning

confidence: 99%

Malpractice Risk According to Physician Specialty

Jena¹,

Seabury²,

Lakdawalla³

et al. 2012

Survey of Anesthesiology

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Background-Data are lacking on the proportion of physicians who face malpractice claims in a year, the size of those claims, and the cumulative career malpractice risk according to specialty.Methods-We analyzed malpractice data from 1991 through 2005 for all physicians who were covered by a large professional liability insurer with a nationwide client base (40,916 physicians and 233,738 physician-years of coverage). For 25 specialties, we reported the proportion of physicians who had malpractice claims in a year, the proportion of claims leading to an indemnity payment (compensation paid to a plaintiff), and the size of indemnity payments. We estimated the cumulative risk of ever being sued among physicians in high-and low-risk specialties. Results-Eachyear during the study period, 7.4% of all physicians had a malpractice claim, with 1.6% having a claim leading to a payment (i.e., 78% of all claims did not result in payments to claimants). The proportion of physicians facing a claim each year ranged from 19.1% in neurosurgery, 18.9% in thoracic-cardiovascular surgery, and 15.3% in general surgery to 5.2% in family medicine, 3.1% in pediatrics, and 2.6% in psychiatry. The mean indemnity payment was $274,887, and the median was $111,749. Mean payments ranged from $117,832 for dermatology to $520,923 for pediatrics. It was estimated that by the age of 65 years, 75% of physicians in lowrisk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties.Conclusions-There is substantial variation in the likelihood of malpractice suits and the size of indemnity payments across specialties. The cumulative risk of facing a malpractice claim is high in all specialties, although most claims do not lead to payments to plaintiffs. (Funded by the RAND Institute for Civil Justice and the National Institute on Aging.) Despite tremendous interest in medical malpractice and its reform, 1-10 data are lacking on the proportion of physicians who face malpractice claims according to physician specialty, the size of payments according to specialty, and the cumulative incidence of being sued during the course of a physician's career. 11-13 A recent American Medical Association (AMA) survey of physicians showed that 5% of respondents had faced a malpractice claim during the previous year. 14 Studies estimating specialty-specific malpractice risk from actual claims are much less recent, 15,16 including a Florida study from 1975 through 1980 showing that 15% of medical specialists, 34% of obstetricians and anesthesiologists, and 48% of

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Urological Malpractice: Analysis of Indemnity and Claim Data From 1985 to 2007

Cited by 26 publications

References 8 publications

Urological litigation in the UK National Health Service (NHS): an analysis of 14 years of successful claims

Urological litigation in the UK National Health Service (NHS): an analysis of 14 years of successful claims

Malpractice Risk According to Physician Specialty

Malpractice Risk According to Physician Specialty

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