A Malpractice Claims Study of a Family Medicine Department: A 20-Year Review

This study describes medical malpractice claims from a large academic family medicine department over 20 years. The intent of this investigation is to analyze trends within the department, seeking to better understand how to improve the quality of patient care.

The Office of Patient Relations and Clinical Risk (PRCR) at University of Michigan Health maintains a centralized database of family medicine malpractice claims dating back to 1987. Records from 2000 to 2020 were requested from this database and received in a deidentified manner to protect patient confidentiality, and as such this study was exempt from IRB review. A total of 55 claims occurred during this time period. These claims were then analyzed in both qualitative and quantitative terms.

Of the 55 claims, 87.3% involved adult patients; 76.5% of the claims occurred in the outpatient setting; 98.1% of the claims involved attending physicians and 26.9% involved resident physicians; 54.5% of the claims were closed without payment and 43.6% of the claims were settled. The average settled claim amount was $742,110.50 which dropped to $160,838.59 after excluding obstetric claims. In addition, 61.8% of the claims were related to diagnosis related allegations and 16.4% of the claims involved treatment related allegations. Primarily involving allegations of missed or delayed diagnoses of cancer, 29.1% of the claims were cancer related. While 79.2% of settled claims did not meet standard of care, 83.3% of the claims closed without payment did meet standard of care.

Most claims involved adult patients, occurred in the outpatient setting, and involved diagnosis related allegations. Although representing a minority of the claims, obstetric claims made up most of the total settlement amount. Missed or delayed diagnoses of cancer were a common cause for claims, reinforcing the important role that primary care physicians have in supervising and administering preventative health care to patients. This study also emphasizes the value of peer review committees to help inform medical-legal consultants as evidenced by the high correlation between standard of care determination and final claims outcomes.