Flaws in Clinical Judgment and Communication Gaps Are Leading Factors in Malpractice Cases Closed with Large Payments

HOMEMedical InsightsFlaws in Clinical Judgment and Communication Gaps Are Leading Factors in Malpractice Cases Closed with Large Payments

Flaws in Clinical Judgment and Communication Gaps Are Leading Factors in Malpractice Cases Closed with Large Payments

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

EmPRO believes that having an awareness of the lapses that lead to high indemnity payments in malpractice claims can help insured practitioners improve their clinical care of patients and consequently reduce their risk of being sued. An in-depth analysis of 162 of EmPRO/PRI’s claims asserted over a 4-year period where the indemnity payment was greater than $450,000 revealed thought provoking insights1. {Table 1}.

 

Table 1

 

Patient assessments are often guided by the patient’s history. Obtaining an inadequate history, or overlooking an element of the patient’s history, can result in a physician failing to order a lab test or recommending a scan that may have led to a timelier diagnosis. In addition, some malpractice claims result from practitioners “holding on” to a patient who would have benefited from an evaluation or treatment by a specialist. It is prudent to recognize that some patients, particularly those with complex medical issues, are sometimes better served by a specialist who either assumes the care of the patient or co- treats the patient with the primary care physician. In these instances, ensuring effective transmission of information and a clear agreement of responsibility for aspects of the patient’s ongoing care is crucial.

It is imperative that communication with patients and families is clear and unambiguous, particularly when a diagnosis of cancer or other potentially serious condition is suspected. Documentation of all advice and instructions given to the patient concerning follow-up is essential.

1EmPRO 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 who insure healthcare providers and facilities. This data is drawn from EmPRO/PRI’s study of its claims.
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 own exposure to such events.

We welcome your comments and feedback.

Sanford Goldberg M.D. S.Goldberg@medmal.com

Philip Robbins M.D. P.Robbins@medmal.com

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