'Never events' tied to one of six med-mal claims

Four recognized categories of hospital-acquired conditions, "never events" that have received more attention in recent years, make up 12.2% of total medical professional liability costs, according to the 2008 Hospital Professional Liability and Physician Liability Benchmark Analysis released recently by risk management services provider Aon Corp. and the American Society for Healthcare Risk Management (ASHRM), both in Chicago.

Hospital-acquired infections, hospital-acquired injuries, objects left in surgery, and pressure ulcers account for one out of every six claims, the report says.

On Oct. 1, the Centers for Medicare & Medicaid Services ended reimbursement for 10 specific hospital-acquired conditions — often referred to as "never events." The new research shows that never events are more than just a freak occurrence, says Greg Larcher, director and actuary of Aon Global Risk Consulting and author of the analysis. The study shows that they make up an alarming portion of medical malpractice cases.

"The increased awareness surrounding these nonreimbursable conditions may cause a rise in the frequency of related hospital professional liability claims, not to mention other hospital-acquired conditions not currently addressed by CMS regulations," Larcher says. "This study marks the first time these conditions have been benchmarked, and provides a baseline moving forward for this essential piece of the liability picture."

The study also includes an analysis of professional liability costs for the surgery, obstetrics, and emergency departments. Various supplementary database segments appear in this year's analysis as well, including facility ownership, number of beds and teaching hospitals.

"For the fourth straight year, we are not seeing an increase in the overall number of liability claims," Larcher says. "That said, the not-for-profit segment of the database reflected an increase in claims for the second year."

More than 100 health care organizations representing more than 1,200 facilities, ranging from small community hospitals to large multistate publicly traded health care systems, provided loss and exposure data for the study. The hospital professional liability benchmark database includes 77,705 claims representing $9.3 billion of incurred losses.