Retrospective analysis of medical malpractice claims in tertiary hospitals of China: the view from patient safety

ObjectivesThe study analysed medical malpractice claims to assess patient safety in hospitals. The information derived from malpractice claims reflects potential risks and could help lead to reducing medical errors and improving patient safety.Design, settingWe analysed 4380 medical malpractice claims from 351 grade-A tertiary hospitals in China for 2008–2017. We examined the characteristics of medical errors and patient safety, including the types of medical errors, proportionate liabilities and payments for medical malpractice in different clinical specialties.Main outcome measuresWe assessed claim characteristics, payment amounts and liability.ResultsOur data analysis demonstrated that 72.5% of the claims involved medical errors, with average payments of US$31 430. The hospital’s errors in medical malpractice resulted in 41.4% average liability in patient injury payments. Most medical malpractice cases occurred in Shanghai (817 claims, 18.7%) and Beijing (468 claims, 10.7%). The highest risks for medical error and malpractice claims were related to orthopaedics (11.3% of all claims, 72.8% with medical errors) and obstetrics and gynaecology (10.0% of all claims, 76.0% with medical errors). The highest rates related to proportionate liabilities were observed in otolaryngology (51.9%) and endocrinology (47.7%). Respiratory medicine had the highest proportion of claims in death rates (77.3%). Medical technology errors accounted for 91.8% of the claims and medical ethics errors for 5.8%. The highest average payment was found in cardiovascular surgery (US$41 733) and the lowest in stomatology (US$8822).ConclusionsA previous study found that grade-A tertiary hospitals in China have similar medical error rates to general Chinese hospitals. 36Different specialties had different risk characteristics regarding medical errors, payments and proportionate liabilities. Orthopaedics had the highest number of malpractices claims and higher proportionate liability but lower death rates.

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Patient Safety in Orthopedics and Traumatology

Textbook of Patient Safety and Clinical Risk Management ◽

10.1007/978-3-030-59403-9_19 ◽

2020 ◽

pp. 275-286

Author(s):

Guido Barneschi ◽

Francesco Raspanti ◽

Rodolfo Capanna

Keyword(s):

Patient Safety ◽

High Risk ◽

Medical Malpractice ◽

Clinical Risk ◽

Malpractice Claims ◽

Medical Malpractice Claims

AbstractOrthopedics is a clinical branch considered to be at a high risk for medical malpractice claims. The aim of this work is to analyze the clinical risk and alleged malpractice in order to map professional risk and identify recurrent pitfalls.

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0201 Medical Malpractice Payments Following Mild Sleep Loss and the Daylight Saving Time Shift

SLEEP ◽

10.1093/sleep/zsaa056.199 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A79-A79

Author(s):

C Lage ◽

C Gao ◽

M K Scullin

Keyword(s):

Medical Errors ◽

Medical Error ◽

Emotional Regulation ◽

Medical Malpractice ◽

Emotional Reactions ◽

Medical Liability ◽

Time Shift ◽

Daylight Saving Time ◽

Daylight Saving ◽

Malpractice Claims

Abstract Introduction The national cost of the medical liability system exceeds $10 billion/year, but not all medical errors result in a malpractice claim or payment. Malpractice claims are more likely if the medical error is perceived as severe, if the physician is perceived as lacking empathy, and if negative emotional reactions are triggered in the patient (due to individual or contextual factors). In recent experimental work, participants who were mildly sleep restricted showed an increased propensity to want to punish physicians for medical errors and compensate patients the maximum allowed. Building upon this laboratory work, we evaluated 30 years of medical malpractice claims to determine whether the judgment of final compensation increased after the Spring daylight saving time (DST) shift. Methods We obtained medical malpractice payment data on 373,643 United States cases from the National Practitioner Data Bank (NPDB). We contrasted inflation-adjusted payments across states that have DST shifts relative to non-DST control states (e.g., Arizona, Hawaii). We compared post-Spring DST payments to payments during the two weeks before/after the DST, and averaged payments for the remainder of the year. Results The total number of claims was unrelated to Spring DST, however, the size of malpractice payments significantly increased the week following the spring DST shift relative to non-DST control states and relative to the averaged payments for the remainder of the year. Spring DST was associated with an inflation-adjusted relative increase in malpractice payments by $7,836 to $61,809 per case (depending on comparison). Malpractice payments did not change in relation to the Fall DST shift. Conclusion Mild sleep restriction alters the cognitive and emotional regulation processes that underpin perceptions of medical error severity, willingness to punish, and judgments of appropriate compensation for medical errors. Support N/A

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Malpractice in Cases of Pediatric Appendicitis

Clinical Pediatrics ◽

10.1177/0009922816656621 ◽

2016 ◽

Vol 56 (3) ◽

pp. 226-230 ◽

Cited By ~ 3

Author(s):

Veronica F. Sullins ◽

Joshua D. Rouch ◽

Steven L. Lee

Keyword(s):

Patient Safety ◽

Medical Malpractice ◽

Pediatric Patients ◽

Improve Patient Safety ◽

Timely Diagnosis ◽

Malpractice Claims ◽

Common Causes ◽

Medical Malpractice Claims ◽

Improve Patient ◽

Retrospective Database

Appendicitis is one of the most common diagnoses in children and is frequently the focus of alleged malpractice. Causes for medical malpractice claims and outcomes of disputes in pediatric patients with appendicitis are currently unknown. A retrospective database review of all medical malpractice claims concerning the diagnosis of appendicitis from 1984 to 2013 in pediatric patients was performed. Alleged claims, causes of malpractice, and outcomes were recorded and analyzed. Of the 203 included cases, failure or delays in diagnosing appendicitis are the most common causes of malpractice lawsuits and account for the majority of the largest payments to plaintiffs outcomes. Cases that ultimately went to trial resulted in defense verdicts in 67.5%. Mortality occurred in 19.9% of included cases. Timely diagnosis of appendicitis in children should be the focus of physicians across all specialties to improve patient safety and potentially reduce medicolegal liability.

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Characteristics of the medical malpractice cases against orthopedists in China between 2016 and 2017

PLoS ONE ◽

10.1371/journal.pone.0248052 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0248052

Author(s):

Hongzhi Lv ◽

Dongzheng Li ◽

Chao Li ◽

Peizhi Yuwen ◽

Zhiyong Hou ◽

...

Keyword(s):

Medical Errors ◽

Medical Malpractice ◽

Clinical Characteristics ◽

Final Analysis ◽

Factors Associated ◽

Patient Demographics ◽

Malpractice Claims ◽

Poor Treatment ◽

Medical Malpractice Claims ◽

Improve Patient

Background This study aimed to identify the most frequent reasons for orthopedic medical malpractice, gain insight into the related patient demographics and clinical characteristics, and identify the independent factors associated with it. Methods We collected and analyzed the demographic and injury characteristics, hospital levels and treatments, medical errors, and orthopedist’s degree of responsibility for the patients who were subject to orthopedic medical malpractice at our institution. Univariate and multivariate analyses were performed to identify the factors associated with the orthopedist’s degree of responsibility in the medical malpractice cases. Results We included 1922 cases of medical malpractice in the final analysis. There were 1195 and 727 men and women, respectively (62.2% and 37.8%, respectively). Of the total patients, 1810, 1038, 1558, 1441, and 414 patients (94.2%, 54.0%, 81.1%, 75.0%, and 21.5%, respectively) were inpatients, had closed injuries, underwent surgery, were trauma cases, and had preoperative comorbidities, respectively. Most medical malpractice cases were in patients with fractures and spinal degenerative disease (1229 and 253 cases; 63.9% and 13.2%, respectively), and occurred in city-level hospitals (1006 cases, 52.3%), which were located in the eastern part of china (1001, 52.1%), including Jiangsu and Zhejiang (279 and 233 cases, 14.52% and 52.1%, respectively). Between 2016 and 2017, the orthopedist’s degree of responsibility in medical malpractice claims were deemed as full, primary, equal, secondary, and minor in 135, 654, 77, 716, and 340 orthopedists (7.0%, 34.0%, 4.0%, 37.3%, and 17.7%). Most medical errors made by orthopedists in cases of medical malpractice were related to failure to supervise or monitor cases, improper performance of procedures, and failure to instruct or communicate with the patient (736, 716, and 423 cases; 38.3%, 37.3%, and 22.0%, respectively). The multivariate analysis found that patients with preoperative comorbidities, who sustained humerus injuries, who were aged ≥65 years, who were treated by doctors who failed to supervise or monitor them, and who were treated at the provincial and city level hospitals were more likely to claim that the orthopedist bore a serious degree of responsibility in the medical malpractice case. Conclusions Our results provide detailed information on the plaintiff demographics, clinical characteristics, and factors associated with medical malpractice. Medical malpractice is related to poor treatment outcomes. The first preventative measure that is required is a comprehensive improvement in the medical staff quality, mainly through medical ethics cultivation, and professional ability and technique training. Additionally, failure to supervise or monitor cases was the leading cause of medical malpractice and one of the factors that led to orthopedists bearing an equal and higher responsibility for medical malpractice. Orthopedists should improve patient supervision, especially when treating older patients and those with preoperative comorbidities and humerus injuries.

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Vital Signs: Top 10 Medical Malpractice Claims Against Dermatologists

Skin & Allergy News ◽

10.1016/s0037-6337(05)70778-6 ◽

2005 ◽

Vol 36 (11) ◽

pp. 2

Keyword(s):

Medical Malpractice ◽

Vital Signs ◽

Malpractice Claims ◽

Medical Malpractice Claims

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Faculty Opinions recommendation of Do health system errors cause medical malpractice claims?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1163297.624995 ◽

2009 ◽

Author(s):

Frederick Cheney

Keyword(s):

Health System ◽

Medical Malpractice ◽

Malpractice Claims ◽

System Errors ◽

Medical Malpractice Claims

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Lawsuits against plastic surgeons: Does locale affect incidence of claims?

Canadian Journal of Plastic Surgery ◽

10.1177/229255030701500309 ◽

2007 ◽

Vol 15 (3) ◽

pp. 155-157 ◽

Cited By ~ 3

Author(s):

Jonathan L Kaplan ◽

Warren C Hammert ◽

James E Zin

Keyword(s):

United States ◽

Emergency Room ◽

Plastic Surgery ◽

Medical Malpractice ◽

The United States ◽

Absolute Number ◽

Malpractice Claims ◽

High Incidence ◽

Medical Malpractice Claims ◽

Geographical Locations

Background Physicians continue to practice in a very litigious environment. Some physicians try to mitigate their exposure to lawsuits by avoiding geographical locations known for their high incidence of medical malpractice claims. Not only are certain areas of the United States known to have a higher incidence of litigation, but it is also assumed that certain areas of the hospital incur a greater liability. There seems to be a medicolegal dogma suggesting a higher percentage of malpractice claims coming from patients seen in the emergency room (ER), as well as higher settlements for ER claims. Objective To determine if there is any validity to the dogma that a higher percentage of malpractice claims arise from the ER. Methods An analysis of common plastic surgery consults that result in malpractice claims was performed. The location where the basis for the lawsuit arose – the ER, office (clinic) or the operating room (OR) – was evaluated. The value of the indemnity paid and whether its value increased or decreased based on the location of the misadventure was evaluated. Results According to the data, which represented 60% of American physicians, there was a larger absolute number of malpractice claims arising from the OR, not the ER. However, the highest average indemnity was paid for cases involving amputations when the misadventure originated in the ER. Conclusions The dogma that a greater percentage of lawsuits come from incidents arising in the ER is not supported. However, depending on the patient's injury and diagnosis, a lawsuit from the ER can be more costly than one from the OR.

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A detailed analysis of pediatric surgical malpractice claims in Germany: what is the probability of a pediatric surgeon to be accused or convicted?

Langenbeck s Archives of Surgery ◽

10.1007/s00423-020-02069-6 ◽

2021 ◽

Author(s):

Sara Mahler ◽

Emilio Gianicolo ◽

Oliver J. Muensterer

Keyword(s):

Medical Malpractice ◽

Pediatric Surgeon ◽

Technical Errors ◽

Surgical Technical ◽

Malpractice Claims ◽

Incorrect Diagnosis ◽

Calculated Risk ◽

Medical Malpractice Claims ◽

Observation Period

Abstract Aim of the study Pediatric surgeons treat a vulnerable population in which unfavorable outcome can lead to substantial long-term costs, placing them at risk for malpractice claims. This study aims to characterize the frequency and circumstances in which malpractice claims were successfully brought against pediatric surgeons in Germany over the last 5 years. Materials and methods Anonymous data on medical treatment errors and payments were acquired from the Federal Chamber of Physicians from 2014 through 2018 and analyzed for most frequent diagnoses and circumstances that resulted in accusation or conviction. Those claims that were successfully rebutted were compared to as controls. Lifetime risk for being involved in litigation and its outcome was calculated. Results There were 129 medical malpractice claims over the 5-year observation period. Medical error was confirmed in 56 cases (43%); the rest were successfully appealed. The risk of the prototypical German pediatric surgeon to be accused was 5.24% and to be convicted 2.27% per year in practice. The most common reasons for conviction (alone or in combination) were surgical-technical errors (23%), treatment delay (21%), insufficient workup (17%), incorrect diagnosis (17%), and incomplete consent (16%).The most frequent circumstances leading to a conviction were trauma (27%), inguinal hernia (7%), circumcision (7%), testicular torsion (7%), acute abdomen (7%), and appendicitis (5%). Conclusion Over a 40-year career, pediatric surgeons in Germany face an average calculated risk of 2.1 to be accused and 0.9 to be convicted of malpractice claims. Certain circumstances pose higher risks for litigation than others. Knowledge of these patterns may help practitioners avoid medicolegal confrontation.

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