medical malpractice, litigation

Epidemiology

• 49% of physicians have been named in a lawsuit
  • 41% were involved in suits where other parties were also named
  • 11% were involved in suits where they were the only person named
• among primary care physicians facing lawsuits, 39% have been sued multiple times
• > 90% of physicians surprised by the lawsuit
• Most common reasons for lawsuit
  • failure to diagnose or delay in diagnosis 43%
  • poor outcome, disease progression 25%
  • failure to treat or delay in treatment 20%
  • wrongful death 20%
  • complications from surgery or treatment 15%

Notes

• institutional litigation risk has little to do with overall quality of care
• malpractice reform alone will not reduce the cost the use of high-cost medical imaging in the emergency department
• 1% of all physicians account for 32% of paid malpractice claims
• risk for recurrent malpractice claims 4 times as great for neurosurgeons as psychiatrists
• communication-&-resolution programs can lower malpractice costs,
  • identify potential medical errors or outcomes that involve serious potential harm likely to lead to litigation
  • high-level multidisciplinary assessments of whether mistakes were made & resultant legal exposure
  • proactive communication with patients & families to disclose & explain errors & potential consequences
  • offer financial compensation when appropriate
  • commit to legal defense if no error is believed to have occurred
  • patients expect specific features
    • use of term 'reconciliation rather than 'resolution'
    • information of efforts to improve patient safety because of the error
• efforts to reduce malpractice liability have not translated into improved quality of patient care

Additional terms

• disclosure of unanticipated outcome
• medical ethics