Day on Torts
The following is taken from an article in Clinical Advisor:
A new study has revealed mostly good news for anesthesiologists – since 2005, anesthesia-related medical malpractice claims have decreased dramatically, particularly in inpatient situations. The study, “Comparison and Trends of Inpatient and Outpatient Anesthesia Claims Reported to the National Practitioner Data Bank,” examined inpatient and outpatient anesthesia-related clinician malpractice claims between 2005 and 2013. The study was presented at the 2015 Annual Meeting of the American Society of Anesthesiologists.
During the 9-year study period, anesthesia-related medical malpractice claim frequency decreased by a total of 41.4% (or 4.6% per year). Inpatient claims saw the greatest decrease (a total of 45.5%), while the decrease was significantly less in outpatient settings (a total of 23.5%). According to study author Richard J. Kelly, MD, JD, MPH, FCLM, an anesthesiologist from the University of California, Irvine School of Medicine, the proportion of claims for outpatient procedures has actually increased compared with inpatients, but the amount paid for outpatient claims is significantly less than for inpatient claims.
Of the 2,408 malpractice claim payments made from 2005 to 2013, the 1,841 (76.5%) were for inpatient events, and 567 (or 23.5%) were for outpatient events. The majority of claimants were women (54.4%), outpatient (57.8% versus 53.4% for inpatient), and between the ages of 40 and 59. Over 38% of all paid claims were for injuries resulting in death. The median payment for all anesthesia-related claims was $245,000, with inpatient claims being more expensive than outpatient. Median inpatient claim was $261,742 versus $189,349 for outpatient claims. Payments for inpatient claims accounted for 82.6% of total costs.
Other things being equal, one would have expected claims to increase, given the increase in population thus number of procedures. There are two possible explanations for reduction in claim frequency. First, tort reform measures adopted in the last decade have impacted the number of claims and there is little doubt that is a partial cause. In Tennessee, claims are down about 40%, and while it would be a total guess to say that impacted each practice area equally, it is not unreasonable to find a relationship between increased restrictions on the right to a patient to bring a claim and a jury to award damages and a reduced number of claims.
A second explanation is that the anesthesia community has taken steps to improve patient safety, thus reducing injuries and therefore claims. My reading in this area has caused me to conclude that this is true – the anesthesia community has aggressively focused on improving patient safety. (Click on the link to read about the history of the Anesthesia Patient Safety Foundation.) The anesthesia community should be applauded for its efforts. I am confident that they will continue to identify risks and develop protocols to prevent patient injury and death. And I hope that, when preventable errors occur, that community will support the right of patients to seek compensation for the harm done. Legal accountability for one’s conduct is an important part of improving safety.