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Of ED malpractice claims that closed during a 10-year period, 42% involved diagnosis, according to CNA’s Hospital Professional Liability Claim Report 2015. CNA is a Chicago-based provider of professional liability insurance. (The full report is available at www.cna.com/healthcare.)
“Examples of allegations related to diagnosis include delay in establishing a diagnosis, failure to or delay in obtaining or addressing diagnostic test results, and failure to diagnose and misdiagnosis,” says Joyce Benton, CNA’s assistant vice president for risk control. Here are some actual cases, all of which settled for $1 million:
The ED was one of the top three locations in regard to frequency, and was one of the top five in regard to average total paid claims by location. The top five average total paid claims by clinical service, in order, were perinatal, behavioral health, surgery, medicine, and emergency medicine.
“We were surprised that claims occurring in the ED were not one of the top three locations in regard to average total paid for closed claims by location,” Benton says. Here are other findings:
“Self-insured retentions and other possible sources of payment for other parties, such as noninsured physicians, in response to a claim cannot be determined, and therefore, are not included in this report,” she says.
“These allegations have the highest average severity,” Benton says. In one such case, a patient was evaluated in the ED and determined to meet the criteria for involuntary commitment.
“While waiting for admission, she eloped and could not be found. Soon after, she was struck by a car and sustained fatal injuries,” Benton says.
Financial Disclosure: The following individuals disclose that they have no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study: Arthur R. Derse, MD, JD, FACEP (Physician Editor); Kay Ball, PhD, RN, CNOR, FAAN (Nurse Planner); Stacey Kusterbeck (Contributing Editor); Shelly Morrow Mark (Executive Editor); Jonathan Springston (Associate Managing Editor); Mary Malone (Author); W. Clay Landa (Author); and Megan Dhillon (Author).