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An update on pediatric anesthesia liability: a closed claims analysis
Nathalia Jimenez1, Karen L Posner, Frederick W Cheney
1Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington 98195-6540, USA.
Anesthesia and Analgesia
|December 21, 2006
Summary
Pediatric anesthesia malpractice claims decreased overall, but death and brain damage remained significant injuries in the 1990s. Cardiovascular and respiratory events were primary causes of liability in these pediatric anesthesia claims.
Area of Science:
- Anesthesiology
- Medical Malpractice Law
- Pediatric Patient Safety
Background:
- Respiratory complications comprised 50% of pediatric malpractice claims in the 1970s-1980s.
- Advances in pediatric anesthesia practice may have influenced liability trends.
Purpose of the Study:
- To evaluate trends in pediatric anesthesia malpractice claims from 1973-2000.
- To identify damaging events and injuries associated with severe outcomes in the 1990s.
Main Methods:
- Reviewed 532 pediatric malpractice claims (age <=16) from 1973-2000.
- Utilized logistic regression to analyze trends and factors associated with death/brain damage (BD).
Main Results:
- A decrease in claims for death/BD and respiratory events was observed from 1973-2000.
- In the 1990s, death/BD were dominant injuries, with cardiovascular and respiratory events as most common damaging causes.
- Cardiovascular events (OR=6.6), respiratory events (OR=3.7), and ASA status 3-5 (OR=3.1) were associated with death/BD claims.
Conclusions:
- Death/BD remained the leading injuries in pediatric anesthesia malpractice claims during the 1990s.
- Cardiovascular events emerged as a significant source of liability alongside respiratory events.
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