Characteristics of medical malpractice claims involving emergency medicine physicians

Identifying characteristics of malpractice claims involving emergency medicine (EM) physicians allows leaders to develop patient safety initiatives to prevent future harm events.

A retrospective study was performed of paid/unpaid claims closed 2007 to 2016 from Comparative Benchmarking System. Claims were identified by physician specialty involved (EM, internal medicine, general surgery). Various characteristics were compared by physician specialty. Multivariable regression was performed to identify factors associated with claim payment, in which (1) physician specialty was included as a predictor and (2) only the subset involving EM physicians was analyzed.

Of 54,772 claims, 2760 involved EM physicians, 5886 involved internists, and 3207 involved surgeons. Death was the most common severity among EM claims (34%). Diagnosis-related allegations accounted for 58%, higher than 42% and 11% of claims involving internists and surgeons, respectively (P < 0.0001). Thirty-one percent was paid. The median indemnity paid on behalf of any defendant was $206,261 (interquartile range $55,065-527,651). The most common final diagnoses were myocardial infarction (2%), pulmonary embolus (2%), and cardiac arrest (2%). Procedure-related claims were associated with increased payment likelihood (odds ratio 1.21, 95% confidence interval 1.10-1.34).

Malpractice claims in EM are often diagnosis- or procedure related. Our findings suggest that diagnostic accuracy and procedural competency should shape future quality improvement work.