Professional liability in a neonatal intensive care unit: a review of 20 years' experience

To examine neonatal intensive care unit (NICU) malpractice claims and identify common characteristics likely to result in malpractice.

A retrospective study (1972 to 1992) at a tertiary care children's hospital examining malpractice claims involving NICU infants.

A total of 31 cases of malpractice out of 9367 NICU admissions (incidence 0.33%) were found. Although not statistically significant, the incidence of legal action increased with NICU growth from 0.19% (1972 to 1974) to 0.39% (1980 to 1992). Infants who were significantly over-represented in malpractice cases compared with the general NICU population included those who were full-term, white, privately insured, and those with neurologic conditions. Families' motives for legal action included (1) treatment error/delay (48%), (2) missed/delayed diagnosis (16%), (3) equipment malfunction/misuse (6%), and (4) general improper care (30%).

Based on this research, three factors may be associated with increased risk of malpractice in the NICU: (1) increased unit growth, (2) parental perceptions of negligence, and (3) full-term infants with diagnoses associated with neurologic conditions.