Home E-Weekly June 20, 2017

What We Can Learn From 5 Years of Malpractice Claims Data

Published: June 19, 2017

STAY SAFE Outpatient surgery triggered 250% fewer claims than inpatient surgery, according to the claims analysis.

What differentiates outpatient surgery malpractice claims from inpatient claims? While the types of problems seen in both surgical settings are nearly identical, the severity and volume of issues is almost always worse in the inpatient setting, according to an analysis of 5 consecutive years (2011-2015) of malpractice claims data at Coverys, a leading provider of medical professional liability insurance protection.

  • Substantially fewer claims were triggered from outpatient surgery — 250% fewer than inpatient surgery claims.
  • Retained foreign object claims represent 5.08% of outpatient surgical claims compared to 8.52% of inpatient claims.
  • Intubation-related claims are 3 times more frequent in the inpatient setting than in the outpatient setting.
  • Nearly 20% of inpatient surgical claims were considered high injury/severity (including death) compared to 13% of outpatient surgical claims.
  • Improper surgical techniques related to an unexpected technical problem in the OR are cited in about 19% of inpatient surgical claims versus 11% of outpatient claims.
  • Poor clinical judgment allegations occurred 4 times more frequently in inpatient claims compared to outpatient claims.
  • GI surgeries are the most common type of surgery to trigger a claim in the hospital setting, and the fifth most common in outpatient settings.
  • The highest percentage of claims for outpatient surgery are attributed to elective procedures that are cosmetic in nature (laser and dermatology surgery), as well as orthopedic surgery and general surgery (mostly colonoscopy).
  • For inpatient surgeries, the highest percentage of claims are related to cholecystectomy, hysterectomy, spinal surgery, knee surgery and hernia repair.
Bill Donahue

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