Failure to Diagnose Cancer is a Leading Cause of Malpractice Claims and Payments

HOMEMedical InsightsFailure to Diagnose Cancer is a Leading Cause of Malpractice Claims and Payments

Failure to Diagnose Cancer is a Leading Cause of Malpractice Claims and Payments

Posted by: Sanford Goldberg M.D. and Philip Robbins M.D.
Co-Chief Medical Officers for EmPRO Insurance Company

EmPRO is a member of the prestigious CRICO Strategies Comparative Benchmarking System (CBS). The CBS database contains over 450,000 medical malpractice cases and includes the in-depth coding and analysis of member companies’ claims. This allows member companies from across the country to better understand and analyze the causes and costs of medical malpractice cases and to compare their cases with similar companies that insure healthcare providers and facilities. EmPRO believes it is important to share this valuable information with our Insureds to help you understand the common causes of malpractice claims and help you to mitigate your exposure to such events.

Through an analysis of our claims data, we identified 162 high-indemnity claims (i.e. payments/reserves over $450,000) asserted over a 4-year period, accounting for over $140 million in incurred losses. Of these 162 cases, 98 had a diagnosis-related allegation (defined as diagnosis- failed, delayed or wrong). While diagnosis-related cases accounted for the majority (60%) of the 162 cases studied, their impact was even more significant when considered as a percentage of total incurred losses [70% ($90,300,670)].

Cancer-related diagnoses accounted for 67% of diagnosis-related cases, with breast cancer [18%], lung cancer [17%], and cancer of the urinary system [11%] as the three leading cancer types identified {figure 1}.

Being aware of these common malpractice claims can help practitioners mitigate their risk of lawsuits by making sure that patients who present with pertinent symptoms are aggressively followed to confirm that appropriate diagnostic testing is completed. Practitioners should also ensure that appropriate screening tests are recommended for patients and make certain that the results of such testing are received and reviewed for further action. There should be documentation of all recommendations for testing and evaluations. Any non-compliance by the patient in following their provider’s recommendations should also be specifically documented as this information can be critical to the defense of a malpractice claim alleging a failure or a delayed diagnosis of cancer.

We welcome your comments and feedback.

Sanford Goldberg M.D.

Philip Robbins M.D.