Investigation of obstetric malpractice closed claims: profile of event

The files of 220 obstetric closed-claim cases were reviewed by five obstetricians to determine whether information could be collected an analyzed to identify common predisposing factors to claims and to suggest preventative measures. The data suggests these cases contain common easily identified obstetric risk factors, most of which occurred in labor and delivery (66%). Fifty-four percent of the risks were recognized, 32% correctly managed, and a high percentage of risks were considered by the reviewers to be directly related to the obstetric outcome leading to the claim (66%). The authors feel obstetric closed claims can be studied and suggestions made to aid obstetricians in providing care. Identification of common obstetric risks and correct management of these risks is poor in these cases. Recognition and management guidelines are imperative in ensuring good obstetric outcome. These two physician-controlled factors played important parts in the majority of cases reviewed. It would appear from this study that obstetric malpractice closed claims are amenable to study; physicians and their patients would benefit from better data collection systems to identify risks in individual pregnancies; physicians need readily available resources to aid their management of patients; only through modification of physician behavior can suits be avoided.