Emergency medicine physicians are more prone to be sued for diagnosis-related issues than many other specialists because they treat patients who are unknown to them and who have a broad range of clinical problems, according to a recent study.
A study issued recently by The Doctors Company, based in Napa, CA, and the nation’s largest physician-owned medical malpractice insurer, showed that one of the top claims against emergency physicians was failure to diagnose, which was also a leading cause of patient injury.
The study of 332 emergency medicine claims that closed from 2007-2013 revealed the four most common patient allegations and the percentage of claims:
- diagnostic-related issues, such as failure to establish a differential diagnosis or failure to consider available clinical information (57%);
- improper management of treatment, such as failure to stabilize a patient’s neck following an accident with trauma to head and neck, resulting in paraplegia (13%);
- improper performance of a treatment or procedure, such as intubation of the respiratory tract (5%);
- failure to order medication, such as not initiating fibrinolytic therapy in stroke within the recommended timeframes (3%).
Physicians reviewed the data and noted that inadequate patient assessment, found in 52% of cases, was the top contributor to failures in diagnosis. This category included not using available clinical information. Other factors that were identified as contributing to injury included:
- patient factors, such as obesity, which in some cases delayed the delivery of care due to lack of adequate equipment for treating or evaluating obese patients (21%);
- communication among providers, including failure to review the medical record (17%);
- communication between patient/family and provider, including inadequate follow-up instructions or language barriers (14%);
- insufficient or lack of documentation, including inadequate documentation about clinical findings (13%);
- workflow and workload concerns that included fewer staff or services available on a weekend, night, or holiday (12%).
In another closed claim study regarding obstetrics, The Doctors Company reviewed more than 800 obstetrical claims between 2007 and 2014 and found that obstetricians are most commonly sued for:
- delay in treatment of fetal distress (22%);
- improper performance of vaginal delivery (20%);
- improper management of pregnancy (17%).