Data: OB payment is twice the average

The report on obstetrics claim from Crico Strategies reinforces some of the facts that make risk managers worry about their OB units. The average payment in OB-related malpractice claims is more than twice that of other clinical areas, according to "2010: Annual Benchmarking Report, Malpractice Risks in Obstetrics" released by Crico Strategies. OB-related malpractice claims averaged $980,000, versus $371,000 for non-OB cases.

One data point does show some improvement, however. In analyzing how often OB patients sue, there used to be a wide disparity among academic and community hospitals, with 2005 data showing 10.9 lawsuits per 10,000 births in academic hospitals versus 5.2 for community hospitals. The most recent data shows those figures almost the same, with 6.0 cases per 10,000 births in academic hospitals and 5.4 in community hospitals.

These are some other findings from the report:

Sixty-five percent of OB cases involve high-severity injuries, including maternal and fetal deaths.

The most common allegations are delay in treatment of fetal distress, cited in 25% of cases at hospitals with more than 2,000 births per year and 19% of hospitals with fewer births per year; improper performance of operative vaginal delivery, cited in 15% and 18% of those groups, respectively; and improper management of pregnancy, cited in 13% and 20% of those groups respectively. The most common contributions to OB claims are substandard clinical judgment (found in 77% of the cases), miscommunication (36%), technical error (26%), inadequate documentation (26%), administrative failures (23%), and ineffective supervision (15%).

Birth asphyxia was the most frequent OB case type, accounting for 27% of cases, and the average indemnity was $1,431,000. The next most common types were shoulder dystocia (18% and $559,000), intrauterine fetal death (6% and $373,000), and maternal hemorrhage (4% and $305,000).