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Published on: September 26, 2018
Characteristics of medical professional liability claims in patients with cardiovascular diseases
William J Oetgen1, P Divya Parikh, Joseph G Cacchione
1Division of Cardiology, Georgetown University School of Medicine, Washington, District of Columbia, USA. oetgenw@georgetown.edu
Abstract:
This report presents data describing a large cohort of closed cardiovascular medical professional liability (MPL) claims. The Physician Insurers Association of America established a registry of closed MPL claims in 1985. This registry contains data describing 230,624 closed claims for 28 medical specialties through 2007. The registry is maintained to support educational programs designed to improve the quality of care and to reduce patient injury and MPL claims. In this report, descriptive techniques are used to present summary information for the medical cardiovascular claims in the registry. Of 230,624 closed claims, 4,248 (1.8%) involved cardiovascular medical physicians. Of the 4,248 closed cardiovascular medical claims, 770 (18%) resulted in indemnity payments, and the average indemnity payment was $248,291. In the entire database, 30% of closed claims were paid, and the average indemnity payment was $204,268. The most common allegation among cardiovascular closed claims was diagnostic error, and the most prevalent diagnosis was coronary atherosclerosis. Claims involving cardiac catheterization and coronary angioplasty represented 12% and 7% of the cardiovascular closed claims. Aortic aneurysms and dissections, although relatively infrequent as clinical events, represent a substantial MPL risk because of the high percentage of paid claims (30%) and the very high average indemnity payment of $417,298. In conclusion, MPL issues are common and are important to all practicing cardiologists. Detailed knowledge of risks associated with liability claims should assist practicing cardiologists in improving the quality of care, reducing patient injury, and reducing the incidence of claims.
Insights
Cardiovascular physicians face significant medical professional liability (MPL) risks, with diagnostic errors being the most common allegation. Understanding these risks can help improve patient care and reduce claims.
Area of Science:
- Medical Law and Ethics
- Cardiovascular Medicine
- Risk Management
Background:
- A large registry of closed medical professional liability (MPL) claims, established in 1985 by the Physician Insurers Association of America, contains data on 230,624 claims across 28 specialties through 2007.
- The registry aims to support educational initiatives focused on enhancing care quality, minimizing patient harm, and decreasing MPL claims.
Purpose of the Study:
- To present descriptive data on cardiovascular medical professional liability claims within the established registry.
- To identify common allegations, diagnoses, and procedures associated with cardiovascular MPL claims.
- To analyze the financial impact of these claims, including indemnity payments.
Main Methods:
- Descriptive statistical techniques were applied to analyze a cohort of closed cardiovascular MPL claims.
- Data from the Physician Insurers Association of America's registry (through 2007) were examined.
- Claims involving cardiovascular physicians were specifically extracted and analyzed.
Main Results:
- Cardiovascular physicians accounted for 1.8% (4,248) of the total 230,624 closed claims.
- 18% (770) of cardiovascular claims resulted in indemnity payments, averaging $248,291, compared to 30% and $204,268 for all specialties.
- Diagnostic error was the most frequent allegation, with coronary atherosclerosis being the most common diagnosis. Aortic aneurysm/dissection claims had a high payment rate (30%) and average indemnity ($417,298).
Conclusions:
- Medical professional liability is a significant concern for practicing cardiologists.
- Knowledge of specific risks, such as diagnostic errors and high-risk procedures like cardiac catheterization and angioplasty, can guide efforts to improve patient safety.
- Reducing patient injury and the incidence of MPL claims is achievable through a detailed understanding of liability risks.
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