Patterns in malpractice payments for anesthesia-related claims among CRNAs and physicians

Certified Registered Nurse Anesthetists (CRNAs) now deliver much of US anesthesia care, especially in rural areas, yet contemporary evidence comparing their malpractice payments with those of physicians remains limited.

Using 2011-2023 National Practitioner Data Bank Public Use File data, we examined anesthesia-related malpractice payments, comparing payment characteristics, injury severity, and allegation types for CRNAs and physicians. We estimated adjusted probabilities of severe injury using bias-reduced logistic regression and analyzed national workforce data to provide context for interpreting malpractice payment patterns.

Among 3775 anesthesia-related malpractice payments, severity patterns were similar for CRNAs and physicians. In adjusted models with continuous year and state fixed effects, the probability of severe injury was 57.1% (95% CI, 37.1%-74.6%) for physicians and 55.9% (95% CI, 35.5%-74.2%) for CRNAs, an adjusted difference of -1.2 percentage points (95% CI roughly -21 to +19). Most events occurred in inpatient settings, and patient age clustered in the 50 seconds.

National NPDB data show broadly comparable malpractice payment patterns and claim severity for CRNAs and physicians. These findings inform federal and state discussions on anesthesia workforce configuration, access to care, and liability environments, and may guide policymakers evaluating supervision requirements, workforce distribution, and risk-management strategies.